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General NPI Number Information
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NPI Number | 1942631486
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Entity Type | Organization
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Legal Business Name | WINTER PARK ELDERLY SERVICES
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 1759 ALABAMA DR
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City | WINTER PARK
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State | FL
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Zip | 32789-2648
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Country | US
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Telephone | 407-622-5076
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Fax |
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Provider Business Mailing Address
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Address Line | 1759 ALABAMA DR
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City | WINTER PARK
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State | FL
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Zip | 32789-2648
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Country | US
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Telephone | 407-622-5076
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Fax |
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Authorized Official
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Title or Position | ADMNISTRATOR-RN
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Name | JENNIFER BROWN
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Credential |
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Telephone | 407-252-6408
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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 | AL37
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License Number State | FL
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