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Organization

CENTER FOR INDEPENDENT LIVING INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DONNA JEAN IACONA (ADM)
(772) 460-2108
Entity
Organization

Contact information

Practice address
4700 BUCHANAN DR, FORT PIERCE, FL 34982-7108
(772) 460-2108
(772) 466-0969
Mailing address
4700 BUCHANAN DR, FORT PIERCE, FL 34982-7108
(772) 460-2108
(772) 466-0969

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10026
FL

Other

Enumeration date
02/09/2008
Last updated
02/09/2008
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