Provider Demographics
NPI:1578988044
Name:BOWE'S RETIREMENT HOME INC.
Entity Type:Organization
Organization Name:BOWE'S RETIREMENT HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-465-3453
Mailing Address - Street 1:2739 CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34946-6657
Mailing Address - Country:US
Mailing Address - Phone:772-465-3453
Mailing Address - Fax:772-465-3453
Practice Address - Street 1:2739 CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34946-6657
Practice Address - Country:US
Practice Address - Phone:772-465-3453
Practice Address - Fax:772-465-3453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11797310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility