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General NPI Number Information
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NPI Number | 1902386733
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Entity Type | Organization
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Legal Business Name | SONATA VERO BEACH LLC
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 2425 20TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-6615
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Country | US
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Telephone | 772-770-2401
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Fax | 772-770-0313
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Provider Business Mailing Address
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Address Line | 2425 20TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-6615
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Country | US
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Telephone | 772-770-2401
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Fax | 772-770-0313
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BRENT ATWELL
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Credential |
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Telephone | 772-770-2401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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