Provider Demographics
NPI:1568705937
Name:PERSONAL TOUCH II ALF INC
Entity Type:Organization
Organization Name:PERSONAL TOUCH II ALF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-292-3790
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-0147
Mailing Address - Country:US
Mailing Address - Phone:352-292-3790
Mailing Address - Fax:352-292-3792
Practice Address - Street 1:524 BAHIA CIRCLE RUN
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2680
Practice Address - Country:US
Practice Address - Phone:352-292-3790
Practice Address - Fax:352-292-3792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000556700Medicaid