Provider Demographics
NPI:1386013589
Name:HOUSE OF HONOR THE WESTBROOKS
Entity Type:Organization
Organization Name:HOUSE OF HONOR THE WESTBROOKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTBROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-607-7555
Mailing Address - Street 1:8090 TIPPIN AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6357
Mailing Address - Country:US
Mailing Address - Phone:850-607-7555
Mailing Address - Fax:850-607-2527
Practice Address - Street 1:8090 TIPPIN AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6357
Practice Address - Country:US
Practice Address - Phone:850-607-7555
Practice Address - Fax:850-607-2527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12413310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility