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General NPI Number Information
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NPI Number | 1306144183
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Entity Type | Organization
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Legal Business Name | DOREENS ASSISTED LIVING HOME
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 3045 S SEACREST BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8140
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Country | US
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Telephone | 561-364-7056
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Fax | 561-364-9913
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Provider Business Mailing Address
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Address Line | 3045 S SEACREST BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8140
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Country | US
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Telephone | 561-364-7056
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Fax | 561-364-9913
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DOREEN E. DAIGLE
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Credential |
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Telephone | 561-364-7056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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