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General NPI Number Information
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NPI Number | 1902274897
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Entity Type | Organization
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Legal Business Name | CARING HANDS RESIDENCE, LLC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 1661 REDFIN DR
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City | POINCIANA
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State | FL
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Zip | 34759-4709
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Country | US
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Telephone | 863-496-7260
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Fax | 863-496-5428
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Provider Business Mailing Address
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Address Line | 1661 REDFIN DR
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City | POINCIANA
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State | FL
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Zip | 34759-4709
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Country | US
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Telephone | 863-496-7260
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Fax | 863-496-5428
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Authorized Official
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Title or Position | ALF, ADMINISTARTOR
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Name | MS. LISA J MCMILLAN
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Credential | RN
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Telephone | 407-873-3662
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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 | AL12559
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License Number State | FL
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