NPI 1013350560

Charmaine Harden

Organisation Adult Care Home Facility Port Saint Lucie, FL

Practice location

Address: 6908 NW Kowal CT, Port Saint Lucie, FL 34986-4639
Phone: (561) 574-3171

Authorised official

Name: Charmaine Harden
Title: Administrator
Phone: (561) 574-3171

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 6906117 (FL)

Other Custodial Care Facility providers in Florida →

Registry record

NPI: 1013350560
Entity type: Organization
NPI issued: 15 Apr 2013
Record last updated: 15 Apr 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.