| NPI Details | |
|---|---|
| NPI | 1255776811 |
| Enumeration Date | 05/08/2013 |
| Last Updated | 05/08/2013 |
| Entity Type | Healthcare Provider |
| Active | Over 4 years ago |
| Authorized Information | |
|---|---|
| Name | SHELLEY ANN SHELLEY |
| Position | EXECUTIVE DIRECTOR |
| Phone | (321) 383-2112 |
| Fax | (321) 383-1058 |
| Practice Location | |
|---|---|
| 497 N WASHINGTON AVE TITUSVILLE FL, 32796-2839, US |
|
| Phone | (321) 383-2112 |
| Fax | (321) 383-1058 |
| Business Location | |
|---|---|
| 497 N WASHINGTON AVE TITUSVILLE FL, 32796-2839, US |
|
| Phone | (321) 383-2112 |
| Fax | (321) 383-1058 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 310400000X |
| License State | Florida |
| License Number | 11575 |
| Remove 1255776811 NPI Number | |
According to our database, Principal Senior Living Group NPI is 1255776811, taxonomy code is 310400000X and license number is 11575, license state is located at Florida. Principal Senior Living Group physically located at 497 N Washington Ave, Titusville FL, 32796-2839. NPI Number 1033115704 has the healthcare provider type.
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1255776811 NPI number is provided on an as is basis without warranty of any kind. 1255776811 is maintained by the National Plan & Provider Enumeration System. The contents of Principal Senior Living Group are for informational purposes only.
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