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General NPI Number Information
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NPI Number | 1225156342
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Entity Type | Organization
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Legal Business Name | POLK COUNTY BOCC ELDERLY SERVICES DIVISION
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1290 GOLFVIEW AVE
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City | BARTOW
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State | FL
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Zip | 33830-6738
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Country | US
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Telephone | 863-534-5320
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Fax | 863-534-0314
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Provider Business Mailing Address
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Address Line | 1290 GOLFVIEW AVE
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City | BARTOW
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State | FL
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Zip | 33830-6738
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Country | US
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Telephone | 863-534-5320
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Fax | 863-534-0314
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Authorized Official
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Title or Position | DIVISION DIRECTOR
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Name | MS. HOPE LAYNE JONES
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Credential | RN
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Telephone | 863-534-5548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 088150300
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License Number State | FL
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