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Organization

LILAC HOUSE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. AMBER BROOKS (MANAGER)
(321) 458-8327
Entity
Organization

Contact information

Practice address
1770 S LILAC CIR, TITUSVILLE, FL 32796-3274
(321) 626-6672
Mailing address
1770 S LILAC CIR, TITUSVILLE, FL 32796-3274
(321) 626-6672

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11050
FL

Other

Enumeration date
03/29/2013
Last updated
08/29/2022
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