Provider Demographics
NPI:1144929738
Name:DELORES SHULER-ROWLS
Entity type:Organization
Organization Name:DELORES SHULER-ROWLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHULER ROWLS,
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-510-8893
Mailing Address - Street 1:679 TALL PINE DR
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:FL
Mailing Address - Zip Code:32333-5919
Mailing Address - Country:US
Mailing Address - Phone:850-510-8893
Mailing Address - Fax:
Practice Address - Street 1:679 TALL PINE DR
Practice Address - Street 2:
Practice Address - City:HAVANA
Practice Address - State:FL
Practice Address - Zip Code:32333-5919
Practice Address - Country:US
Practice Address - Phone:850-510-8893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home