Provider Demographics
NPI:1346585452
Name:ORANGE BLOSSOMS VILLA III, LLC
Entity Type:Organization
Organization Name:ORANGE BLOSSOMS VILLA III, LLC
Other - Org Name:ORANGE BLOSSOMS VILLA IV
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-762-1492
Mailing Address - Street 1:11030 56TH PL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8811
Mailing Address - Country:US
Mailing Address - Phone:561-904-0808
Mailing Address - Fax:561-282-6892
Practice Address - Street 1:11030 56TH PL N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-8811
Practice Address - Country:US
Practice Address - Phone:561-904-0808
Practice Address - Fax:561-282-6892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 12283310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility