Provider Demographics
NPI:1538651831
Name:LOREY ALF
Entity Type:Organization
Organization Name:LOREY ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNWE/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WASCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-785-2874
Mailing Address - Street 1:2347 WALNUT CANYON DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-1719
Mailing Address - Country:US
Mailing Address - Phone:407-785-2874
Mailing Address - Fax:
Practice Address - Street 1:2347 WALNUT CANYON DR
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34758-1719
Practice Address - Country:US
Practice Address - Phone:407-785-2874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13140310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility