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General NPI Number Information
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NPI Number | 1801206222
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Entity Type | Organization
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Legal Business Name | LA MAISON LAMIER INC.
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 127 W BLUE HERON BLVD
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4428
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Country | US
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Telephone | 561-557-8208
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Fax | 561-841-5208
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Provider Business Mailing Address
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Address Line | 127 W BLUE HERON BLVD
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-4428
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Country | US
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Telephone | 561-557-8208
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Fax | 561-841-5208
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Authorized Official
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Title or Position | CEO
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Name | MRS. RITA K CRICHLOW
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Credential | LPN
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Telephone | 561-281-0644
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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 | AL12492
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License Number State | FL
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