Provider Demographics
NPI:1083360523
Name:DONNA'S ASSISTED LIVING FACILITY II LLC
Entity Type:Organization
Organization Name:DONNA'S ASSISTED LIVING FACILITY II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-505-1770
Mailing Address - Street 1:149 HAGERSTOWN ST SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-7631
Mailing Address - Country:US
Mailing Address - Phone:321-505-1770
Mailing Address - Fax:
Practice Address - Street 1:720 SEVEN GABLES CIR SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-6622
Practice Address - Country:US
Practice Address - Phone:321-505-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility