Provider Demographics
NPI:1174909584
Name:EVELYNE PIARD GROUP HOME
Entity type:Organization
Organization Name:EVELYNE PIARD GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-307-2347
Mailing Address - Street 1:672 KINGSBURY ST E
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-0731
Mailing Address - Country:US
Mailing Address - Phone:781-307-2348
Mailing Address - Fax:
Practice Address - Street 1:754 BAHAMA AVE S
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33974-9791
Practice Address - Country:US
Practice Address - Phone:239-368-2636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities