| Organization Name: | CHARMAINE HARDEN |
| NPI Number: | 1013350560 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARMAINE HARDEN (ADMINISTRATOR) |
| Mailing Address: | 6908 Nw Kowal Ct Port Saint Lucie |
| State: | FL US |
| Postal Code: | 349864639 |
| Phone Number: | 5615743171 |
| Fax Number: | |
| NPI Enumeration Date: | 04/15/2013 |
| NPI Last Update Date: | 04/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311ZA0620X |
| License Number: | 6906117 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Custodial Care Facility |
| Taxonomy Specialization: | Adult Care Home |
| Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |