Healthcare Provider Details

I. General information

NPI: 1265723456
Provider Name (Legal Business Name): PERSONAL TOUCH ASSISTED LIVING FACILITY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 FIR TRAIL COURSE
OCALA FL
34472
US

IV. Provider business mailing address

PO BOX 147
OCALA FL
34478
US

V. Phone/Fax

Practice location:
  • Phone: 352-292-3244
  • Fax:
Mailing address:
  • Phone: 352-292-3244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number11730
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number11730
License Number StateFL

VIII. Authorized Official

Name: MS. JACQULINE R LILLY
Title or Position: PRESIDENT
Credential:
Phone: 352-484-9533