Florida Assistant Living Organization, LLC
Organization Active NPI Assisted Living Facility · Madison, FL
NPI 1740690171 · NPPES record last updated May 7, 2014
Key facts
- NPI
- 1740690171
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- 10295 (FL)
- Legal business name
- FLORIDA ASSISTANT LIVING ORGANIZATION, LLC
- Practice address
- 219 SE Abernathy Way
Madison, FL 32340-7044 - Phone
- (850) 973-2415
- NPI assigned
- May 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Willie M. Peacock
- Title
- Administrator
- Phone
- (850) 973-2380
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Falo Hill
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 10295 | FL | Yes |
Addresses
Primary practice location
219 SE Abernathy Way
Madison, FL 32340-7044
Mailing address
240 SE Stephens Ave
Madison, FL 32340-2656
Phone (850) 973-2380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003217202 | Medicaid | FL |
Other names
- Florida Assistant Living Organization Chateau
Other providers in Madison, FL
- Matesha Fead
- Kenol Junior Felix
- Juanita Webb Fico
- Florida Assistant Living Organization, LLC
- Florida Assistant Living Organization, LLC
- Florida Department of Health
- James C Flournoy Sr.
- Courtney Strickland Floyd
- Deshala Frazier
- Elizabeth Fulford
All providers in Madison, FL · Assisted Living Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.