Healthcare Provider Details

I. General information

NPI: 1396296141
Provider Name (Legal Business Name): ALMARK COVE ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2016
Last Update Date: 10/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 ARROW LN
ORLANDO FL
32808-3301
US

IV. Provider business mailing address

13920 EYLEWOOD DR
WINTER GARDEN FL
34787-4664
US

V. Phone/Fax

Practice location:
  • Phone: 407-656-2443
  • Fax:
Mailing address:
  • Phone: 407-656-2443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberAL9378
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License NumberAL9378
License Number StateFL

VIII. Authorized Official

Name: MR. TEXUS WALLACE
Title or Position: OWNER
Credential:
Phone: 407-656-2443