Provider Demographics
NPI:1568116754
Name:WINDRHON GROUP HOME
Entity Type:Organization
Organization Name:WINDRHON GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:561-309-2688
Mailing Address - Street 1:4572 MYRTLE LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5314
Mailing Address - Country:US
Mailing Address - Phone:561-697-8053
Mailing Address - Fax:561-686-7756
Practice Address - Street 1:4572 MYRTLE LN
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5314
Practice Address - Country:US
Practice Address - Phone:561-309-2688
Practice Address - Fax:561-686-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683753196Medicaid