Provider Demographics
NPI:1326438763
Name:LORIG AND LORIG
Entity Type:Organization
Organization Name:LORIG AND LORIG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:B
Authorized Official - Last Name:LORIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-890-6488
Mailing Address - Street 1:3131 GATLIN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-7017
Mailing Address - Country:US
Mailing Address - Phone:321-208-7143
Mailing Address - Fax:321-208-7143
Practice Address - Street 1:3131 GATLIN DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-7017
Practice Address - Country:US
Practice Address - Phone:321-208-7143
Practice Address - Fax:321-208-7143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11703310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility