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General NPI Number Information
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NPI Number | 1568116754
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Entity Type | Organization
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Legal Business Name | WINDRHON GROUP HOME
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Dates
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Enumeration Date | 02/07/2022
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Last Update Date | 02/07/2022
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Provider Practice Location Address
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Address Line | 4572 MYRTLE LN
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-5314
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Country | US
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Telephone | 561-309-2688
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Fax | 561-686-7756
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Provider Business Mailing Address
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Address Line | 4572 MYRTLE LN
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-5314
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Country | US
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Telephone | 561-697-8053
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Fax | 561-686-7756
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. RHONA PALMER
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Credential | BSN
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Telephone | 561-309-2688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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