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General NPI Number Information
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NPI Number | 1295171130
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Entity Type | Organization
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Legal Business Name | CAPE WEST
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | 4614 SW 7TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33914-6442
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Country | US
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Telephone | 239-540-7385
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 SW 7TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33914-6442
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Country | US
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Telephone | 239-540-7385
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SOLIENNE DARBOUZE
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Credential |
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Telephone | 239-839-8002
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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 | AL11886
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License Number State | FL
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