| Beachland Retirement Home | |
|
462 Hernando St Fort Pierce FL 34949-3243 | |
| (772) 460-8007 | |
| (772) 460-8007 |
| Full Name | Beachland Retirement Home |
|---|---|
| Speciality | Clinic/center |
| Location | 462 Hernando St, Fort Pierce, Florida |
| Authorized Official Name and Position | Roman Grochowski (ADMINISTRATOR/OWNER) |
| Authorized Official Contact | 7724608007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beachland Retirement Home 462 Hernando St Fort Pierce FL 34949-3243 Ph: (772) 460-8007 | Beachland Retirement Home 462 Hernando St Fort Pierce FL 34949-3243 Ph: (772) 460-8007 |
| NPI Number | 1376981985 |
|---|---|
| Provider Enumeration Date | 06/06/2013 |
| Last Update Date | 06/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376981985 | NPI | - | NPPES |
| 675980700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 8841 (Florida) | Primary |
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