Healthcare Provider Details

I. General information

NPI: 1043489032
Provider Name (Legal Business Name): KARE ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4314 BLONIGEN AVE
ORLANDO FL
32812-8002
US

IV. Provider business mailing address

2715 UINTAH AVE
ORLANDO FL
32805-6270
US

V. Phone/Fax

Practice location:
  • Phone: 407-674-7005
  • Fax: 407-674-7000
Mailing address:
  • Phone: 407-674-7005
  • Fax: 407-674-7000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL11143
License Number StateFL

VIII. Authorized Official

Name: MRS. LAUREN ANN SAMAAN
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 407-402-5616