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General NPI Number Information
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NPI Number | 1245590934
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Entity Type | Organization
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Legal Business Name | CIERRA'S PLACE INC
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 5356 KINGFISHERS CT
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City | TALLAHASSEE
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State | FL
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Zip | 32303-8918
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Country | US
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Telephone | 850-524-4921
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Fax |
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Provider Business Mailing Address
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Address Line | 5356 KINGFISHERS CT
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City | TALLAHASSEE
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State | FL
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Zip | 32303-8918
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Country | US
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Telephone | 850-524-4921
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CARRIE RHODES
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Credential |
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Telephone | 850-524-4921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 5199913
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License Number State | FL
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