Provider Demographics
NPI:1275425415
Name:HYLTON RESIDENTIAL SUITES LLC
Entity type:Organization
Organization Name:HYLTON RESIDENTIAL SUITES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-589-4520
Mailing Address - Street 1:6118 NW DUKE CIR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3336
Mailing Address - Country:US
Mailing Address - Phone:954-589-4520
Mailing Address - Fax:
Practice Address - Street 1:6118 NW DUKE CIR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-3336
Practice Address - Country:US
Practice Address - Phone:954-589-4520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility