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NPI Code Detail

MEDICARE: PAT'S LOVING CARE ALF INC.

MEDICARE: PAT'S LOVING CARE ALF INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityAL12818FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508212010
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAT'S LOVING CARE ALF INC.
Provider Business Mailing Address
First Line : 3783 BIRCH MOUNTAIN RD
Second Line :
City : PORT ORANGE
State : FL
Zip : 32129-3770
Country : US
Telephone Number : 386-275-5869
Fax Number :
Provider Business Practice Location Address
First Line : 3783 BIRCH MOUNTAIN RD
Second Line :
City : PORT ORANGE
State : FL
Zip : 32129-3770
Country : US
Telephone Number : 386-275-5869
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. PATRICIA PEARSON
Credential :
Telephone Number : 386-275-5869
Provider Enumeration Date : 05/13/2016
Last Update Date : 05/13/2016

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Directions to “PAT'S LOVING CARE ALF INC. ” Practice Location

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