Provider Demographics
NPI:1063025823
Name:CARING VILLAGE AT FOREST GLEN LLC
Entity Type:Organization
Organization Name:CARING VILLAGE AT FOREST GLEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-609-7614
Mailing Address - Street 1:7200 CAMINO REAL STE 200
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5511
Mailing Address - Country:US
Mailing Address - Phone:561-925-2501
Mailing Address - Fax:
Practice Address - Street 1:7435 PLATHE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-4554
Practice Address - Country:US
Practice Address - Phone:954-609-7614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility