Healthcare Provider Details

I. General information

NPI: 1275971608
Provider Name (Legal Business Name): AJR LOVING CARE ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

638 WHITE CRANE CT
CHULUOTA FL
32766-6673
US

IV. Provider business mailing address

5900 DEAN RD
OVIEDO FL
32765-8333
US

V. Phone/Fax

Practice location:
  • Phone: 407-671-6161
  • Fax: 407-699-0160
Mailing address:
  • Phone: 407-671-6161
  • Fax: 407-699-0160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number11356
License Number StateFL

VIII. Authorized Official

Name: MRS. ANNE BARLATIER
Title or Position: OWNER
Credential:
Phone: 407-459-2403