Provider Demographics
NPI:1225291594
Name:LOMONICO MANAGEMENT CORP
Entity Type:Organization
Organization Name:LOMONICO MANAGEMENT CORP
Other - Org Name:HIGHLANDS VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:HEARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-402-0406
Mailing Address - Street 1:2301 US HWY 27 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-4941
Mailing Address - Country:US
Mailing Address - Phone:863-402-0406
Mailing Address - Fax:863-402-1453
Practice Address - Street 1:2301 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-4941
Practice Address - Country:US
Practice Address - Phone:863-402-0406
Practice Address - Fax:863-402-1453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9069310400000X, 3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142462900Medicaid