Organization · NPI-2

Beachland Retirement Home

Clinic/Center · Fort Pierce, FL

NPI number1376981985
StatusActive
Last updated in NPPESJun 6, 2013

Details

NPI
1376981985
Entity type
Organization (NPI-2)
Legal business name
Beachland Retirement Home
Organization subpart
No
Enumeration date
Jun 6, 2013
Last updated
Jun 6, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center8841FLYes

Practice location

462 Hernando St
Fort Pierce, FL 34949-3243

Phone 772-460-8007 · Fax 772-460-8007

Mailing address

462 Hernando St
Fort Pierce, FL 34949-3243

Phone 772-460-8007 · Fax 772-460-8007

Authorized official

Roman Grochowski
Administrator/Owner
7724608007

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