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General NPI Number Information
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NPI Number | 1295282432
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Entity Type | Organization
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Legal Business Name | ARBOR VILLAGE HOME, LLC
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 965 6TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-5990
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Country | US
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Telephone | 561-401-8260
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Fax |
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Provider Business Mailing Address
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Address Line | 965 6TH AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-5990
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LUCSEN SAINTIL
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Credential |
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Telephone | 561-401-8260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | AL12768
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License Number State | FL
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