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General NPI Number Information
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NPI Number | 1043821564
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Entity Type | Organization
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Legal Business Name | HIBISCUS OAKS, LLC
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1385 HIBISCUS AVE
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City | WINTER PARK
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State | FL
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Zip | 32789-1611
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Country | US
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Telephone | 407-622-5076
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Fax |
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Provider Business Mailing Address
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Address Line | 1759 ALABAMA DR
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City | WINTER PARK
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State | FL
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Zip | 32789-2648
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Country | US
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Telephone | 407-622-5076
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIFER BROWN
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Credential |
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Telephone | 407-252-6408
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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 |
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License Number State |
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