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General NPI Number Information
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NPI Number | 1720566110
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Entity Type | Organization
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Legal Business Name | CIRCLE OF FRIENDS ASSISTED LIVING FACILITY
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Dates
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Enumeration Date | 07/30/2018
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Last Update Date | 07/30/2018
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Provider Practice Location Address
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Address Line | 3708 MEADOW BROOK AVE
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City | ORLANDO
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State | FL
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Zip | 32808
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Country | US
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Telephone | 407-760-2349
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Fax | 407-760-2349
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Provider Business Mailing Address
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Address Line | 3708 MEADOWBROOK AVE
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City | ORLANDO
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State | FL
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Zip | 32808-0033
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Country | US
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Telephone | 407-760-2349
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Fax | 407-760-2349
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. KISLENE ST.HUBERT
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Credential |
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Telephone | 407-760-2349
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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 |
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License Number State | FL
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