Healthcare Provider Details

I. General information

NPI: 1497985774
Provider Name (Legal Business Name): ARLENE LAROSCAIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 HART LAKE DR
WINTER HAVEN FL
33884-4145
US

IV. Provider business mailing address

670 HART LAKE DR
WINTER HAVEN FL
33884-4145
US

V. Phone/Fax

Practice location:
  • Phone: 863-298-5022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. ARLENE LAROSCAIN
Title or Position: RPT
Credential: RPT
Phone: 863-307-7081