MEDICARE: THE HOUSE OF CARES ALF INC. AT MEADOWLARK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1285331330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HOUSE OF CARES ALF INC. AT MEADOWLARK

Provider Business Mailing Address
First Line	:	1042 SW HALEYBERRY AVE
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34953-6750
Country	:	US
Telephone Number	:	561-667-3361
Fax Number	:

Provider Business Practice Location Address
First Line	:	151 MEADOWLARK DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-2966
Country	:	US
Telephone Number	:	561-667-3361
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	FILICIA PORTER
Credential	:
Telephone Number	:	561-667-3361

Provider Enumeration Date	:	02/09/2023
Last Update Date	:	02/09/2023

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