Provider Demographics
NPI:1710154497
Name:THE PLACE AT STUART
Entity Type:Organization
Organization Name:THE PLACE AT STUART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:PHARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-287-9909
Mailing Address - Street 1:860 SE CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3978
Mailing Address - Country:US
Mailing Address - Phone:772-287-9909
Mailing Address - Fax:772-287-4014
Practice Address - Street 1:860 SE CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3978
Practice Address - Country:US
Practice Address - Phone:772-287-9909
Practice Address - Fax:772-287-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8963310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility