Healthcare Provider Details

I. General information

NPI: 1467449249
Provider Name (Legal Business Name): WEST ORANGE HEALTHCARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N DILLARD ST
WINTER GARDEN FL
34787-2816
US

IV. Provider business mailing address

411 N DILLARD ST
WINTER GARDEN FL
34787-2816
US

V. Phone/Fax

Practice location:
  • Phone: 407-296-1600
  • Fax: 407-296-1639
Mailing address:
  • Phone: 407-296-1600
  • Fax: 407-296-1639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF15940961
License Number StateFL

VIII. Authorized Official

Name: MRS. LORI JOWETT
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 407-296-1614