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General NPI Number Information
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NPI Number | 1184542458
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Entity Type | Organization
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Legal Business Name | NH ASL DUNEDIN TENANT, LLC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 2010 GREENBRIAR BLVD
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City | CLEARWATER
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State | FL
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Zip | 33763-1454
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Country | US
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Telephone | 727-735-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 1585 BROADWAY FL 33
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City | NEW YORK
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State | NY
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Zip | 10036-0473
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Country | US
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Telephone | 212-761-3649
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | JAMES HICKOK
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Credential |
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Telephone | 212-761-3649
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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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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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