433 ORANGE DRIVE LLC NPI 1003159294

NPI Information

NPI: 1003159294
Provider Name: 433 ORANGE DRIVE, LLC

Doing Business As: GRAND VILLA OF ALTAMONTE SPRINGS

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
433 ORANGE DR
ALTAMONTE SPRINGS, FL
ZIP 32701
Phone: (407) 260-2433
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433 ORANGE DRIVE, LLC is an assisted living facility in Altamonte Springs, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. 433 ORANGE DRIVE, LLC NPI is 1003159294. The provider is registered as an organization entity type.
The provider Is Doing Business As Grand Villa Of Altamonte Springs.

The provider's business location address is:

433 ORANGE DR
ALTAMONTE SPRINGS, FL
ZIP 32701-377
Phone: (407) 260-2433

The provider's authorized official is Dennis Forte .
The authorized official title is Manager and has the following contact phone number (727) 726-3980.

The CLIA number assigned to this NPI record is 10D0958524 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2013 and was last updated on 4/5/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	311500000X	Alzheimer Center (Dementia Center)		AL7103	FLORIDA	No
2	310400000X	Assisted Living Facility		AL7103	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	002973900	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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