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General NPI Number Information
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NPI Number | 1760842595
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Entity Type | Organization
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Legal Business Name | SARAH A ROPER
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 17112 NW CHARLIE JOHNS ST
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City | BLOUNTSTOWN
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State | FL
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Zip | 32424-1308
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Country | US
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Telephone | 850-674-1090
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Fax | 850-674-1090
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Provider Business Mailing Address
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Address Line | 17112 NW CHARLIE JOHNS ST
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City | BLOUNTSTOWN
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State | FL
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Zip | 32424-1308
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Country | US
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Telephone | 850-674-1090
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Fax | 850-674-1090
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Authorized Official
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Title or Position | AR
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Name | SARAH A. ROPER
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Credential |
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Telephone | 850-674-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL12565
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License Number State | FL
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