Local City Search for Care Homes, Nursing Homes, Assisted Living, Skilled Nursing and Home CareSUMMERVILLE AT PORT ORANGE, INC.
Alzheimer Center
Port Orange, Florida
Provider NPI: 1750545158
Organization Information:Organization Name: SUMMERVILLE AT PORT ORANGE, INC.
Practice Location:
1675 DUNLAWTON AVE PORT ORANGE, FL 32127 US
Tel: 386-761-1055 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1675 DUNLAWTON AVE PORT ORANGE, FL 32127 US
Tel: 386-761-1055 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | ||
| Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | FL | AL9792 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 0111336-00 | FL | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin