Organization
VICTORIAN MANOR, INC.
Active
Other names
Victorian Manor, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
NOEMI RODRIGUEZ (ONWNER)
(954) 236-4300
Entity
Organization
Contact information
Practice address
11150 SW 42ND CT, DAVIE, FL 33328-2140
(954) 236-4300
Mailing address
15140 SW 38TH ST, DAVIE, FL 33331-2755
(954) 816-3203
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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