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General NPI Number Information
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NPI Number | 1861890428
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Entity Type | Organization
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Legal Business Name | LA BELLE LA VIE
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 12/15/2014
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Provider Practice Location Address
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Address Line | 3973 LUBEC AVE
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City | NORTH PORT
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State | FL
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Zip | 34287-5131
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Country | US
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Telephone | 813-368-2742
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Fax |
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Provider Business Mailing Address
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Address Line | 3973 LUBEC AVE
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City | NORTH PORT
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State | FL
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Zip | 34287-5131
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Country | US
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Telephone | 813-368-2742
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | MRS. STERELLA MARTINE ABDUL
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Credential | J.D.
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Telephone | 813-368-2742
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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 | 12508
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License Number State | FL
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