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General NPI Number Information
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NPI Number | 1811993025
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Entity Type | Organization
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Legal Business Name | SA-PG-OCALA LLC
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 2700 SW 34TH ST
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City | OCALA
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State | FL
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Zip | 34474-4470
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Country | US
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Telephone | 352-854-6262
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Fax | 352-861-2009
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Provider Business Mailing Address
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Address Line | 2700 SW 34TH ST
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City | OCALA
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State | FL
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Zip | 34474-4470
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Country | US
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Telephone | 352-854-6262
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Fax | 352-861-2009
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Authorized Official
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Title or Position | COO
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Name | MR. ALEX PALEY
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Credential |
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Telephone | 914-390-4363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1411096
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License Number State | FL
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