Healthcare Provider Details

I. General information

NPI: 1437893401
Provider Name (Legal Business Name): SPRING ARBOR APEX NC TENANT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SPRING ARBOR CT
APEX NC
27502-4951
US

IV. Provider business mailing address

420 S ORANGE AVE STE 400
ORLANDO FL
32801-4908
US

V. Phone/Fax

Practice location:
  • Phone: 919-303-9990
  • Fax:
Mailing address:
  • Phone: 407-250-7482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AMY PATTERSON
Title or Position: PARALEGAL
Credential:
Phone: 407-250-7482