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General NPI Number Information
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NPI Number | 1437682515
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Entity Type | Organization
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Legal Business Name | SUMMERS RAIN LLC
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Dates
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Enumeration Date | 04/06/2017
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Last Update Date | 04/06/2017
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Provider Practice Location Address
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Address Line | 2910 SE 2ND ST
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8217
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Country | US
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Telephone | 561-512-4331
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Fax |
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Provider Business Mailing Address
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Address Line | 2910 SE 2ND ST
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-8217
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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/ADMINISTRATOR
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Name | DR. LOVE MANIE PREDELUS
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Credential |
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Telephone | 561-512-4331
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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 | AL12987
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License Number State | FL
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