Organization
SA-PG -PORT ST LUCIE LLC
Active
Other names
Palm Garden of Port St. Lucie
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX PALEY (COO)
(914) 390-4363
Entity
Organization
Contact information
Practice address
1751 SE HILLMOOR DR, PORT ST LUCIE, FL 34952-7535
(772) 335-8844
(772) 335-9954
Mailing address
1751 SE HILLMOOR DR, PORT ST LUCIE, FL 34952-7535
(772) 335-8844
(772) 335-9954
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1419096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025724900
—
FL
Enumeration date
06/22/2005
Last updated
07/22/2008
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