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General NPI Number Information
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NPI Number | 1548507866
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Entity Type | Organization
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Legal Business Name | FESTA ENTERPRISES INC.
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 6722 WINKLER RD
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City | FORT MYERS
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State | FL
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Zip | 33919-7204
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Country | US
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Telephone | 239-433-5553
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Fax | 239-481-9919
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Provider Business Mailing Address
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Address Line | 13860 LILY PAD CIR
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City | FORT MYERS
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State | FL
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Zip | 33907-1825
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Country | US
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Telephone | 239-565-3846
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Fax | 239-481-9919
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DOLORES J FESTA
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Credential | ADMINISTRATOR
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Telephone | 239-565-3846
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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 | 7353
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License Number State | FL
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