Organization
HOME AWAY FROM HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRINETTA C. TAYLOR (OWNER/ADMINISTRATOR)
(561) 719-9138
Entity
Organization
Contact information
Practice address
324 LYMAN PL, WEST PALM BEACH, FL 33409-3651
(561) 719-9138
(561) 682-1209
Mailing address
324 LYMAN PL, WEST PALM BEACH, FL 33409-3651
(561) 719-9138
(561) 682-1209
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141935800
—
FL
Enumeration date
10/02/2014
Last updated
10/02/2014
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