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General NPI Number Information
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NPI Number | 1033618145
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Entity Type | Organization
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Legal Business Name | A & B LIFESTYLE LIVING
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Dates
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Enumeration Date | 02/04/2018
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Last Update Date | 02/04/2018
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Provider Practice Location Address
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Address Line | 301 S MAIN AVE
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City | MINNEOLA
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State | FL
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Zip | 34715-7436
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Country | US
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Telephone | 352-857-6410
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Fax | 352-509-3046
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Provider Business Mailing Address
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Address Line | 5552 SW 93RD LN
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City | OCALA
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State | FL
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Zip | 34476-9580
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Country | US
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Telephone | 352-857-6410
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Fax | 352-509-3046
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Authorized Official
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Title or Position | CO OWNER
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Name | ELMER Y ARCENAL
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Credential |
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Telephone | 352-857-6410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 5456
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License Number State | FL
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