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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. You can also correspond with Nic 4 Bayside Terrace Leasing Llc through the mailing address at PO BOX 1700, NIC 4 BAYSIDE TERRACE LEASING LLC, LAKE OSWEGO, OR - 97035 (mailing address contact number: 971-245-8020).

Location: 9381 U.s. 19, Pinellas Park, FL, 97035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
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
Pinellas Park
State
Florida
Zip
33782
Phone Number
727-576-1234
Fax Number
727-570-2257
person
Provider Business Mailing Address Details
Address
9381 U.s. 19
City
Pinellas Park
State
Florida
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
310400000X
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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