Healthcare Provider Details

I. General information

NPI: 1457924219
Provider Name (Legal Business Name): STARWELL LIVING,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 PINETTA CIR
WELLINGTON FL
33414-6015
US

IV. Provider business mailing address

1337 PINETTA CIR
WELLINGTON FL
33414-6015
US

V. Phone/Fax

Practice location:
  • Phone: 561-422-7059
  • Fax:
Mailing address:
  • Phone: 954-554-3289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: NADEGE ORMELUS
Title or Position: PRESIDENT/MANAGER
Credential:
Phone: 954-554-3289