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General NPI Number Information
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NPI Number | 1023546355
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Entity Type | Organization
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Legal Business Name | NAPLES LITTLE HOUSE INC.
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 05/31/2017
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Provider Practice Location Address
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Address Line | 4231 14TH AVE SE
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City | NAPLES
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State | FL
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Zip | 34117-9201
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Country | US
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Telephone | 239-304-1338
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Fax |
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Provider Business Mailing Address
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Address Line | 4231 14TH AVE SE
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City | NAPLES
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State | FL
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Zip | 34117-9201
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Country | US
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Telephone | 239-304-1338
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Fax | 239-304-1338
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | LESTER M FERNANDEZ
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Credential |
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Telephone | 239-304-1338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 13014
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License Number State | FL
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