MEDICARE: VIRA'S PLACE

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	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1700563525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRA'S PLACE

Provider Business Mailing Address
First Line	:	6566 JACQUES WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7486
Country	:	US
Telephone Number	:	561-543-9445
Fax Number	:	561-968-5887

Provider Business Practice Location Address
First Line	:	6566 JACQUES WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7486
Country	:	US
Telephone Number	:	561-543-9445
Fax Number	:	561-968-5887

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KAREN W CHAMBERS
Credential	:
Telephone Number	:	561-543-9445

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	07/03/2023

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Directions to “VIRA'S PLACE ” Practice Location

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