Provider Demographics
NPI:1316188212
Name:PACOR,INC.
Entity Type:Organization
Organization Name:PACOR,INC.
Other - Org Name:THE CORNERSTONE AT LONGWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORAZON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAGSIYAO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:407-433-6424
Mailing Address - Street 1:480 E CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4290
Mailing Address - Country:US
Mailing Address - Phone:407-767-0500
Mailing Address - Fax:407-767-5005
Practice Address - Street 1:480 E CHURCH AVE
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4290
Practice Address - Country:US
Practice Address - Phone:407-767-0500
Practice Address - Fax:407-767-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL5315310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility