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Organization

SANDRA ADULT FAMILY CARE HOME

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SANDRA M SALOMON (OWNER)
(813) 476-8875
Entity
Organization

Contact information

Practice address
1004 LARWOOD PINE DR, RUSKIN, FL 33570-5334
(813) 476-8875
Mailing address
1004 LARWOOD PINE DR, RUSKIN, FL 33570-5334
(813) 476-8875

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906469
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003716200
FL
Enumeration date
08/21/2013
Last updated
05/19/2015
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