| Home At Last Of Brevard,inc. | |
|
2333 Jupiter Blvd Sw Palm Bay FL 32908-3416 | |
| (321) 508-4639 | |
| Not Available |
| Full Name | Home At Last Of Brevard,inc. |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 2333 Jupiter Blvd Sw, Palm Bay, Florida |
| Authorized Official Name and Position | Alvin Payne (PRESIDENT) |
| Authorized Official Contact | 3215084639 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Home At Last Of Brevard,inc. 2333 Jupiter Blvd Sw Palm Bay FL 32908-3416 Ph: () - | Home At Last Of Brevard,inc. 2333 Jupiter Blvd Sw Palm Bay FL 32908-3416 Ph: (321) 508-4639 |
| NPI Number | 1508169657 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 12/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508169657 | NPI | - | NPPES |
| 674701996 | Other | FL | MEDICAID WAIVER |
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