Provider Demographics
NPI:1063669653
Name:ARDEN COURTS OF PALM HARBOR FL LLC
Entity Type:Organization
Organization Name:ARDEN COURTS OF PALM HARBOR FL LLC
Other - Org Name:ARDEN COURTS OF PALM HARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT-REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5541
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:ATTN BARRY A LAZARUS
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-252-5541
Mailing Address - Fax:419-254-5494
Practice Address - Street 1:2895 TAMPA RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3314
Practice Address - Country:US
Practice Address - Phone:727-771-1600
Practice Address - Fax:727-787-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility