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General NPI Number Information
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NPI Number | 1902084197
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Entity Type | Organization
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Legal Business Name | CHATEAU BLANC, INC
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Dates
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Enumeration Date | 02/10/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 711 CASLER AVE
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City | CLEARWATER
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State | FL
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Zip | 33755-5504
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Country | US
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Telephone | 727-446-0292
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Fax | 727-446-0292
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Provider Business Mailing Address
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Address Line | 711 CASLER AVE
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City | CLEARWATER
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State | FL
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Zip | 33755-5504
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Country | US
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Telephone | 727-446-0292
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Fax | 727-446-0292
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HAIFA K HARB
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Credential |
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Telephone | 727-278-9458
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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 | AL08775
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License Number State | FL
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