MEDICARE: HBP LEASECO, L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311500000X	Alzheimer Center (Dementia Center)
2	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1124250949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HBP LEASECO, L.L.C.

Provider Business Mailing Address
First Line	:	5426 BAY CENTER DR
Second Line	:	SUITE 600
City	:	TAMPA
State	:	FL
Zip	:	33609-3444
Country	:	US
Telephone Number	:	813-287-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2517 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-1314
Country	:	US
Telephone Number	:	813-287-3900
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JON DELUCA
Credential	:
Telephone Number	:	813-287-3900

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	08/12/2009

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