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General NPI Number Information
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NPI Number | 1356520860
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Entity Type | Organization
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Legal Business Name | ELDERLY CARE,INC
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 11 CHRISTIE AVE
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City | SARASOTA
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State | FL
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Zip | 34232-1901
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Country | US
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Telephone | 941-378-3918
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Fax | 941-378-3918
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Provider Business Mailing Address
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Address Line | 11 CHRISTIE AVE
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City | SARASOTA
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State | FL
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Zip | 34232-1901
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Country | US
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Telephone | 941-378-3918
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Fax | 941-378-3918
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RICHARD WONG ENDAYA
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Credential |
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Telephone | 941-378-3918
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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 | 692941996
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License Number State | FL
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