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General NPI Number Information
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NPI Number | 1487060646
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Entity Type | Organization
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Legal Business Name | E & R VB VENTURES, LLC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 1934 22ND AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-3084
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Country | US
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Telephone | 772-794-1277
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Fax |
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Provider Business Mailing Address
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Address Line | 1934 22ND AVE
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City | VERO BEACH
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State | FL
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Zip | 32960-3084
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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 | RICHARD VAN BENSCHOTEN
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Credential |
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Telephone | 772-794-1277
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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 | AL9844
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License Number State | FL
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