Provider Demographics
NPI:1821716390
Name:SLOCUM'S ADULT FAMILY CARE LLC
Entity Type:Organization
Organization Name:SLOCUM'S ADULT FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-304-1797
Mailing Address - Street 1:21321 NE 17TH LOOP
Mailing Address - Street 2:
Mailing Address - City:LAWTEY
Mailing Address - State:FL
Mailing Address - Zip Code:32058-5234
Mailing Address - Country:US
Mailing Address - Phone:352-304-1797
Mailing Address - Fax:
Practice Address - Street 1:21321 NE 17TH LOOP
Practice Address - Street 2:
Practice Address - City:LAWTEY
Practice Address - State:FL
Practice Address - Zip Code:32058-5234
Practice Address - Country:US
Practice Address - Phone:352-304-1797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home