Organization Name: | LAURELWOOD ALF |
NPI Number: | 1023353695 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEONILA VERACRUZ DUFVA (OWNER/ADMINISTRATOR) |
Mailing Address: | 1851 W. Ten Mile Rd Cantonment |
State: | FL US |
Postal Code: | 32533 |
Phone Number: | 8504761246 |
Fax Number: | 8504764225 |
NPI Enumeration Date: | 12/07/2012 |
NPI Last Update Date: | 12/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | AL9554 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |