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General NPI Number Information
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NPI Number | 1144521451
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Entity Type | Organization
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Legal Business Name | CASSIE'S CASTLE
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 208 NATCHEZ TRACE AVE
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1261
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Country | US
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Telephone | 561-204-2800
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Fax | 561-204-2800
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Provider Business Mailing Address
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Address Line | 208 NATCHEZ TRACE AVE
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-1261
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Country | US
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Telephone | 561-204-2800
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Fax | 561-204-2800
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Authorized Official
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Title or Position | OWNER
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Name | MR. LAURISTON GEORGE SIMMS
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Credential |
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Telephone | 561-719-0263
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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 | AL10948
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License Number State | FL
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