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EVELYN'S HOME ASSISTED LIVING LLC NPI 1104313790


NPI Information

NPI: 1104313790
Provider Name: EVELYN'S HOME ASSISTED LIVING LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
2119 BEACON LANDING CIR
ORLANDO, FL
ZIP 32824
Phone: (407) 497-1243
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EVELYN'S HOME ASSISTED LIVING LLC is an assisted living facility in Orlando, 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. EVELYN'S HOME ASSISTED LIVING LLC NPI is 1104313790. The provider is registered as an organization entity type.

The provider's business location address is:

2119 BEACON LANDING CIR
ORLANDO, FL
ZIP 32824-374
Phone: (407) 497-1243
Fax: (407) 888-9121

The provider's authorized official is Florence Woberaere Ejiowhor .
The authorized official title is Owner/administrator and has the following contact phone number (407) 497-1243.

The enumeration date for this NPI number is 4/18/2018 and was last updated on 6/16/2018.


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
1310400000XAssisted Living FacilityAL13064FLORIDAYes

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
1022295400MEDICAIDFLORIDA
21396255139OTHERNPI

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: 5/5/2024
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