Provider Demographics
NPI:1275229726
Name:ANSLEY PARKE AT ORANGE CITY LLC
Entity Type:Organization
Organization Name:ANSLEY PARKE AT ORANGE CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRARD
Authorized Official - Suffix:V
Authorized Official - Credentials:
Authorized Official - Phone:863-226-0358
Mailing Address - Street 1:500 GRAND PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7900
Mailing Address - Country:US
Mailing Address - Phone:366-246-2351
Mailing Address - Fax:
Practice Address - Street 1:500 GRAND PLAZA DR
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7900
Practice Address - Country:US
Practice Address - Phone:366-246-2351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility