Provider Demographics
NPI:1447417852
Name:FLORIDA BAPTIST RETIREMENT CENTERS INC.
Entity Type:Organization
Organization Name:FLORIDA BAPTIST RETIREMENT CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-567-5248
Mailing Address - Street 1:1006 33RD ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6910
Mailing Address - Country:US
Mailing Address - Phone:772-567-5248
Mailing Address - Fax:772-567-7507
Practice Address - Street 1:1006 33RD ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6910
Practice Address - Country:US
Practice Address - Phone:772-567-5248
Practice Address - Fax:772-567-7507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1152096313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility