Provider Demographics
NPI:1346797271
Name:STUART ACQUISITION I LLC
Entity Type:Organization
Organization Name:STUART ACQUISITION I LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEMINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-471-1022
Mailing Address - Street 1:1500 SE PALM BEACH RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4044
Mailing Address - Country:US
Mailing Address - Phone:772-283-5887
Mailing Address - Fax:772-781-4563
Practice Address - Street 1:1500 SE PALM BEACH RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4044
Practice Address - Country:US
Practice Address - Phone:772-283-5887
Practice Address - Fax:772-781-4563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15260962314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105277Medicare Oscar/Certification