Provider Demographics
NPI:1295400554
Name:NAVARRE GARDENS, LLC
Entity Type:Organization
Organization Name:NAVARRE GARDENS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:T
Authorized Official - Last Name:NEWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-723-9367
Mailing Address - Street 1:7254 NAVARRE PKWY
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7753
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7254 NAVARRE PKWY
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7753
Practice Address - Country:US
Practice Address - Phone:850-723-9367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVARRE GARDENS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility