The Wilson Place

NPI 1205194545 - Assisted Living Facility - 310400000X

NPI Details
NPI 1205194545
Enumeration Date 04/24/2012
Last Updated 04/24/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name GRAHAM DUNCAN GRAHAM
Position ADMINISTATOR
Phone (321) 613-2867
Fax (321) 396-7855
Practice Location
117 WILSON AVE
COCOA BEACH FL, 32931-3981, US
Phone (321) 613-2867
Fax (321) 396-7855
Business Location
117 WILSON AVE
COCOA BEACH FL, 32931-3981, US
Phone (321) 613-2867
Fax (321) 396-7855
Toxanomy
Taxonomy Code 310400000X
License State Florida
License Number AL11786
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According to our database, The Wilson Place NPI is 1205194545, taxonomy code is 310400000X and license number is AL11786, license state is located at Florida. The Wilson Place physically located at 117 Wilson Ave, Cocoa Beach FL, 32931-3981. NPI Number 1033115704 has the healthcare provider type.

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1205194545 NPI number is provided on an as is basis without warranty of any kind. 1205194545 is maintained by the National Plan & Provider Enumeration System. The contents of The Wilson Place are for informational purposes only.