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General NPI Number Information
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NPI Number | 1265833131
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Entity Type | Organization
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Legal Business Name | PAMPERED PARENTS, ALF, INC.
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 6 SETON CT
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City | PALM COAST
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State | FL
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Zip | 32164-4430
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Country | US
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Telephone | 386-313-6428
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Fax | 386-313-1679
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Provider Business Mailing Address
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Address Line | 3600 S OCEANSHORE BLVD SUITE 314
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-4100
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Country | US
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Telephone | 407-256-6070
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Fax | 386-313-1676
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | MS. SUSANNA SANFORD KNIGHT
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Credential | CNA
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Telephone | 407-256-6070
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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 | 12487
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License Number State | FL
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