Organization
MAJESTIC BLUE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY-ANN ELLINGTON-ROBINSON (MANAGER)
(857) 222-0249
Entity
Organization
Contact information
Practice address
163 NW DOREEN ST, PORT SAINT LUCIE, FL 34983-1533
(857) 222-0249
Mailing address
163 NW DOREEN ST, PORT SAINT LUCIE, FL 34983-1533
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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