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Nic 4 Balmoral Leasing Llc
Assisted Living Facility in Lake Placid, Florida
NPI 1720422405

Nic 4 Balmoral Leasing Llc is an Assisted Living Facility based in Lake Oswego, FL. Nic 4 Balmoral Leasing Llc practices in Lake Placid, FL. The NPI Number for Nic 4 Balmoral Leasing Llc is 1720422405 and holds a License No. 11307 (Florida).

The current practice location address for Nic 4 Balmoral Leasing Llc is 93 Balmoral Drive, Lake Placid, FL and can be reached out via phone at 863-465-6584 and via fax at 863-465-6585.

Location: 93 Balmoral Drive, Lake Placid, FL, 97035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1720422405
Provider Name
Nic 4 Balmoral Leasing Llc
Credential
Provider Entity Type
Organization
Address
93 Balmoral Drive, Lake Placid, FL, 97035
Phone Number
863-465-6584
Fax Number
863-465-6585
Provider Enumeration Date
04/24/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003688600 01 FL MEDICAID AL WAIVER
institution
Provider Business Practice Location Address Details
Address
93 Balmoral Drive
City
Lake Placid
State
Florida
Zip
33852
Phone Number
863-465-6584
Fax Number
863-465-6585
person
Provider Business Mailing Address Details
Address
93 Balmoral Drive
City
Lake Placid
State
Florida
Zip
33852
Phone Number
863-465-6584
Fax Number
863-465-6585
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
11307 (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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