WICKSHIRE PORT ORANGE OPCO LLC is an assisted living facility in Port Orange, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. WICKSHIRE PORT ORANGE OPCO LLC NPI is 1023616943. The provider is registered as an organization entity type.
The provider's business location address is:
1675 DUNLAWTON AVE
PORT ORANGE, FL
ZIP 32127-755
Phone: (386) 761-1055
The provider's authorized official is Dan O'keefe .
The authorized official title is Ceo and has the following contact phone number (615) 942-0240.
The CLIA number assigned to this NPI record is 10D0990646 - assisted living facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 10/13/2020 and was last updated on 10/13/2020.