Provider Demographics
NPI:1891549523
Name:SOLOMON'S PORCH
Entity Type:Organization
Organization Name:SOLOMON'S PORCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARETAKER
Authorized Official - Prefix:
Authorized Official - First Name:VITTORIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MORBETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-706-9757
Mailing Address - Street 1:2736 SENECA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34946-6666
Mailing Address - Country:US
Mailing Address - Phone:864-706-9757
Mailing Address - Fax:
Practice Address - Street 1:2736 SENECA AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34946-6666
Practice Address - Country:US
Practice Address - Phone:864-706-9757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care