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General NPI Number Information
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NPI Number | 1689837320
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Entity Type | Organization
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Legal Business Name | ABRAMS KOZY CARE
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 2256 SOUTH EAST BOWIE STREET
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952
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Country | US
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Telephone | 772-398-0692
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Fax | 772-398-0692
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Provider Business Mailing Address
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Address Line | 2256 SOUTH EAST BOWIE STREET
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952
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Country | US
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Telephone | 772-398-0692
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Fax | 772-398-0692
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHARON MARIE ABRAMS
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Credential | RN
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Telephone | 772-398-0692
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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 | 10040
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License Number State | FL
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