Healthcare Provider Details

I. General information

NPI: 1609093996
Provider Name (Legal Business Name): ASL OF NEW PORT RICHEY FL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 BAILLIE DR
NEW PORT RICHEY FL
34653-4914
US

IV. Provider business mailing address

5692 STRAND CT
NAPLES FL
34110-3389
US

V. Phone/Fax

Practice location:
  • Phone: 727-842-9899
  • Fax: 727-845-8310
Mailing address:
  • Phone: 239-963-3400
  • Fax: 239-963-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number0007689
License Number StateFL

VIII. Authorized Official

Name: MS. DORENE M FORD
Title or Position: DIRECTOR OF M I S
Credential:
Phone: 239-963-3400