Provider Demographics
NPI:1316372923
Name:FLORIDA LIVING OPTIONS INC
Entity Type:Organization
Organization Name:FLORIDA LIVING OPTIONS INC
Other - Org Name:3RD FLORIDA LIVING OPTIONS LLC HAWTHORNE INN OF BRANDON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-679-7533
Mailing Address - Street 1:859 W LUMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6280
Mailing Address - Country:US
Mailing Address - Phone:813-661-8998
Mailing Address - Fax:813-661-3725
Practice Address - Street 1:859 W LUMSDEN RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6280
Practice Address - Country:US
Practice Address - Phone:813-661-8998
Practice Address - Fax:813-661-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9949310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL 9949OtherASSISTED LIVING LICENSE