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General NPI Number Information
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NPI Number | 1104085307
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Entity Type | Organization
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Legal Business Name | CROWN SENIOR SERVICES, LLC
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/04/2008
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Provider Practice Location Address
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Address Line | 418 CANARY ISLAND CIR
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City | DAVENPORT
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State | FL
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Zip | 33837-5553
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Country | US
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Telephone | 863-424-6306
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Fax |
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Provider Business Mailing Address
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Address Line | 418 CANARY ISLAND CIR
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City | DAVENPORT
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State | FL
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Zip | 33837-5553
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Country | US
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Telephone | 863-424-6306
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUDITH RENE FIGAREAU
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Credential |
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Telephone | 863-424-6306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 230388
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 230388
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License Number State | FL
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