Provider Demographics
NPI: | 1083838197 |
---|---|
Name: | FRANCIS HOME ALF |
Entity Type: | Organization |
Organization Name: | FRANCIS HOME ALF |
Other - Org Name: | HELEN PADILLA |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | HELEN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PADILLA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 727-586-0820 |
Mailing Address - Street 1: | 124 OVERBROOK DR E |
Mailing Address - Street 2: | |
Mailing Address - City: | LARGO |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33770-2823 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 727-586-0820 |
Mailing Address - Fax: | 727-586-0820 |
Practice Address - Street 1: | 124 OVERBROOK DR E |
Practice Address - Street 2: | |
Practice Address - City: | LARGO |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33770-2823 |
Practice Address - Country: | US |
Practice Address - Phone: | 727-586-0820 |
Practice Address - Fax: | 727-586-0820 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-04-12 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | AL10801 | 310400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |