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General NPI Number Information
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NPI Number | 1912238528
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Entity Type | Organization
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Legal Business Name | INDIAN RIVER PRIVATE DUTY NURSING
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 3201 CARDINAL DR SUITE 7
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City | VERO BEACH
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State | FL
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Zip | 32963-4976
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Country | US
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Telephone | 772-231-4442
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 CARDINAL DR SUITE 7
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City | VERO BEACH
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State | FL
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Zip | 32963-4976
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Country | US
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Telephone | 772-231-4442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA ARSENAULT
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Credential | RN
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Telephone | 772-231-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 30211405
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License Number State | FL
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