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Nic 4 Sunset Lake Leasing
Assisted Living Facility in Venice, Florida
NPI 1285078659

Nic 4 Sunset Lake Leasing is an Assisted Living Facility based in Lake Oswego, FL. Nic 4 Sunset Lake Leasing practices in Venice, FL. The NPI Number for Nic 4 Sunset Lake Leasing is 1285078659 and holds a License No. 9325 (Florida).

The current practice location address for Nic 4 Sunset Lake Leasing is 1121 Jacaranda Blvd., Venice, FL and can be reached out via phone at 941-497-1117 and via fax at 941-492-3455.

Location: 1121 Jacaranda Blvd., Venice, FL, 97035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1285078659
Provider Name
Nic 4 Sunset Lake Leasing
Credential
Provider Entity Type
Organization
Address
1121 Jacaranda Blvd., Venice, FL, 97035
Phone Number
941-497-1117
Fax Number
941-492-3455
Provider Enumeration Date
04/29/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003067300 01 FL MEDICAID AGED/DISABLED ADULTS
institution
Provider Business Practice Location Address Details
Address
1121 Jacaranda Blvd.
City
Venice
State
Florida
Zip
34292
Phone Number
941-497-1117
Fax Number
941-492-3455
person
Provider Business Mailing Address Details
Address
1121 Jacaranda Blvd.
City
Venice
State
Florida
Zip
34292
Phone Number
941-497-1117
Fax Number
941-492-3455
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
9325 (Florida)
Definition
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.
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