Provider Demographics
NPI:1487199840
Name:TALLAHASSEE NHHI, LLC
Entity Type:Organization
Organization Name:TALLAHASSEE NHHI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-536-8600
Mailing Address - Street 1:2516 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-2104
Mailing Address - Country:US
Mailing Address - Phone:850-536-8600
Mailing Address - Fax:
Practice Address - Street 1:2516 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-2104
Practice Address - Country:US
Practice Address - Phone:850-536-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAPESTRY SENIOR HOUSING DEVELOPMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12941310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility