Organization · NPI-2

Family Extended Care Of Punta Gorda, INC

Assisted Living Facility · Port Charlotte, FL

NPI number1851695399
StatusActive
Last updated in NPPESDec 24, 2010

Details

NPI
1851695399
Entity type
Organization (NPI-2)
Legal business name
Family Extended Care Of Punta Gorda, INC
Organization subpart
No
Enumeration date
Dec 24, 2010
Last updated
Dec 24, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living FacilityAL5016FLYes

Other names

  • Vick Street Manor (Doing Business As)

Practice location

22332 Vick St
Port Charlotte, FL 33980-2053

Phone 941-627-5388 · Fax 941-627-2007

Mailing address

22332 Vick St
Port Charlotte, FL 33980-2053

Phone 941-627-5388 · Fax 941-627-2007

Authorized official

Debra M Lewis
Director Of Quality Assurance
2392473248

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