Provider Demographics
NPI:1225378243
Name:THORNTON GARDENS III LLC
Entity Type:Organization
Organization Name:THORNTON GARDENS III LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-383-9040
Mailing Address - Street 1:3119 FLORENE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6419
Mailing Address - Country:US
Mailing Address - Phone:407-858-4441
Mailing Address - Fax:866-285-6838
Practice Address - Street 1:3119 FLORENE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6419
Practice Address - Country:US
Practice Address - Phone:407-858-4441
Practice Address - Fax:866-285-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11269310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility