Provider Demographics
NPI:1306199310
Name:AMHEALTHCARE, LLC.
Entity Type:Organization
Organization Name:AMHEALTHCARE, LLC.
Other - Org Name:OAK HAVEN ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DAMIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-862-7421
Mailing Address - Street 1:9040 STAR TRL
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-2541
Mailing Address - Country:US
Mailing Address - Phone:727-862-7421
Mailing Address - Fax:727-378-8537
Practice Address - Street 1:9040 STAR TRL
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-2541
Practice Address - Country:US
Practice Address - Phone:727-862-7421
Practice Address - Fax:727-378-8537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL7684310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001436700Medicaid