Healthcare Provider Details

I. General information

NPI: 1528942265
Provider Name (Legal Business Name): NADINE'S ADULT FAMILY HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 PENNFIELD ST
LEHIGH ACRES FL
33974-9495
US

IV. Provider business mailing address

317 PENNFIELD ST
LEHIGH ACRES FL
33974-9495
US

V. Phone/Fax

Practice location:
  • Phone: 239-399-2744
  • Fax: 239-399-2744
Mailing address:
  • Phone: 239-399-2744
  • Fax: 239-399-2744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: NADINE SINGH
Title or Position: OWNER
Credential: MD
Phone: 239-399-2744