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General NPI Number Information
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NPI Number | 1861796005
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Entity Type | Organization
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Legal Business Name | THE PERFEC PLACE ALF
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 3890 SW CHAFFIN ST
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-5304
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Country | US
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Telephone | 772-985-8841
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Fax | 772-336-4368
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Provider Business Mailing Address
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Address Line | 3890 SW CHAFFIN ST
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City | PORT SAIN LUCIE
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State | FL
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Zip | 34953
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Country | US
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Telephone | 772-985-8841
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Fax | 772-336-4368
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Authorized Official
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Title or Position | OWNER
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Name | REGLA RODRIGUEZ
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Credential |
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Telephone | 772-985-8841
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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 | AL11868
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License Number State | FL
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