MEDICARE: ADULT FAMILY CARE OF WELLINGTON, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	6906518	FL

General Provider Information

NPI Number	:	1396188561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADULT FAMILY CARE OF WELLINGTON, INC.

Provider Business Mailing Address
First Line	:	102 NEWBERRY LN
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33414-4322
Country	:	US
Telephone Number	:	561-784-3960
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 NEWBERRY LN
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33414-4322
Country	:	US
Telephone Number	:	561-784-3960
Fax Number	:

Authorized Official
Title or Position	:	PRES
Name	:	LYNNE A FRITSCHI
Credential	:
Telephone Number	:	561-784-3960

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	04/08/2013

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