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General NPI Number Information
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NPI Number | 1700218328
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Entity Type | Organization
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Legal Business Name | SPECIAL LOVING HOME, INC.
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 652 NW 113TH TER
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-7977
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Country | US
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Telephone | 754-484-7042
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Fax | 754-484-7042
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Provider Business Mailing Address
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Address Line | 652 NW 113TH TER
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-7977
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Country | US
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Telephone | 754-484-7042
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Fax | 754-484-7042
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Authorized Official
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Title or Position | OWNE/RADMINISTRATOR
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Name | MISS CARMEL MARIE JEAN-POIX
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Credential | LPN
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Telephone | 754-484-7042
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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 | AL12246
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License Number State | FL
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