Organization
MLCKM, LLC
Active
Other names
Harbor Oaks Golden Years
Organization subpart
No
Provider details
NPI number
Authorized official
MALGORZATA PTAK (OWNER/ADMINISTRATOR)
(386) 767-1613
Entity
Organization
Contact information
Practice address
158 FARMBROOK RD, PORT ORANGE, FL 32127-6243
(386) 767-1613
Mailing address
158 FARMBROOK RD, PORT ORANGE, FL 32127-6243
(386) 767-1613
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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