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General NPI Number Information
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NPI Number | 1053837203
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Entity Type | Organization
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Legal Business Name | EVERLASTING FAMILY HOME CARE SERVICE II
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 197 PONCE DE LEON ST
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1234
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Country | US
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Telephone | 561-907-6956
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Fax | 561-513-9365
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Provider Business Mailing Address
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Address Line | 197 PONCE DE LEON ST
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1234
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Country | US
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Telephone | 561-907-6956
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Fax | 561-513-9365
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DUVENSON JEANDENIS
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Credential |
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Telephone | 561-907-6956
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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 | AL13045
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License Number State | FL
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