Healthcare Provider Details

I. General information

NPI: 1174872741
Provider Name (Legal Business Name): GUIDANCE CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 41ST STREET OCEAN
MARATHON FL
33050-0000
US

IV. Provider business mailing address

3000 41ST STREET OCEAN
MARATHON FL
33050-0000
US

V. Phone/Fax

Practice location:
  • Phone: 305-434-7660
  • Fax:
Mailing address:
  • Phone: 305-434-7660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberRN9267959
License Number StateFL

VIII. Authorized Official

Name: EWA OWENS
Title or Position: REGISTER NURSE ON A INPATIENT UNIT
Credential: RN
Phone: 305-434-7660