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Ms. Wanda Faye Wilson
Adult Care Home Facility in Monticello, Florida
NPI 1043643133

Wanda Faye Wilson is an Adult Care Home Facility based in Monticello, FL and is specialized in Adult Care Home. Wanda Faye Wilson practices in Monticello, FL. The NPI Number for Wanda Faye Wilson is 1043643133 and holds a License No. 6906542 (Florida).

The current practice location address for Wanda Faye Wilson is 2510 St Augustine Rd, Monticello, FL and can be reached out via phone at 850-780-0426.

Location: 2510 St Augustine Rd, Monticello, FL, 32344-6938
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043643133
Provider Name
Wanda Faye Wilson
Credential
Provider Entity Type
Individual
Gender
Female
Address
2510 St Augustine Rd, Monticello, FL, 32344-6938
Phone Number
850-780-0426
Fax Number
Provider Enumeration Date
08/13/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004873400 05 FL
institution
Provider Business Practice Location Address Details
Address
2510 St Augustine Rd
City
Monticello
State
Florida
Zip
32344-6938
Phone Number
850-780-0426
Fax Number
person
Provider Business Mailing Address Details
Address
2510 St Augustine Rd
City
Monticello
State
Florida
Zip
32344-6938
Phone Number
850-780-0426
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Custodial Care Facility
Speciality
Adult Care Home
Taxonomy
311ZA0620X
License No.
6906542 (Florida)
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
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