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General NPI Number Information
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NPI Number | 1396266961
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Entity Type | Organization
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Legal Business Name | CARING HANDS OF THE TREASURE COAST, LLC
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Dates
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Enumeration Date | 07/04/2017
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Last Update Date | 07/04/2017
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Provider Practice Location Address
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Address Line | 4022 SW BAMBERG ST
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-7029
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Country | US
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Telephone | 954-993-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 599 CALAMINT PT
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-4213
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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 AND ADMINISTRATOR
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Name | MRS. ANGELA MCEWAN
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Credential |
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Telephone | 954-993-7002
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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 | 12995
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License Number State | FL
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