institution
Nic 4 Bayside Terrace Leasing Llc
Assisted Living Facility in Pinellas Park, Florida
NPI 1528402229

Nic 4 Bayside Terrace Leasing Llc is an Assisted Living Facility based in Lake Oswego, FL. Nic 4 Bayside Terrace Leasing Llc practices in Pinellas Park, FL. The NPI Number for Nic 4 Bayside Terrace Leasing Llc is 1528402229 and holds a License No. 6139 (Florida).

The current practice location address for Nic 4 Bayside Terrace Leasing Llc is 9381 U.s. 19, Pinellas Park, FL and can be reached out via phone at 727-576-1234 and via fax at 727-570-2257.

Location: 9381 U.s. 19, Pinellas Park, FL, 97035
institution
Provider Profile Details
NPI Number
1528402229
Provider Name
Nic 4 Bayside Terrace Leasing Llc
Credential
Provider Entity Type
Organization
Address
9381 U.s. 19, Pinellas Park, FL, 97035
Phone Number
727-576-1234
Fax Number
727-570-2257
Provider Enumeration Date
04/24/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004295900 01 FL MEDICAID AL WAIVER
institution
Provider Business Practice Location Address Details
Address
9381 U.s. 19
City
State
Zip
33782
Phone Number
727-576-1234
Fax Number
727-570-2257
person
Provider Business Mailing Address Details
Address
9381 U.s. 19
City
State
Zip
33782
Phone Number
727-576-1234
Fax Number
727-570-2257
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
License No.
6139 (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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