Provider Demographics
NPI:1497098214
Name:COCONUT POINT LIVING LLC
Entity Type:Organization
Organization Name:COCONUT POINT LIVING LLC
Other - Org Name:PLANTATION OAKS SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORRINE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:EUBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:ALF ADMINISTRATOR
Authorized Official - Phone:407-859-7990
Mailing Address - Street 1:9309 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8300
Mailing Address - Country:US
Mailing Address - Phone:407-859-7990
Mailing Address - Fax:407-859-8967
Practice Address - Street 1:9309 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8300
Practice Address - Country:US
Practice Address - Phone:407-859-7990
Practice Address - Fax:407-859-8967
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COCONUT POINT LIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12300310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility