Provider Demographics
NPI:1609213651
Name:GENTLE CARE ASSISTED LIVING, INC.
Entity Type:Organization
Organization Name:GENTLE CARE ASSISTED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRONESTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-569-1399
Mailing Address - Street 1:75 BRUNSWICK LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3627
Mailing Address - Country:US
Mailing Address - Phone:386-569-1399
Mailing Address - Fax:386-447-7730
Practice Address - Street 1:66 BLARE CASTLE DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-7309
Practice Address - Country:US
Practice Address - Phone:386-569-1399
Practice Address - Fax:386-447-7730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10635310400000X
FLAL11197310400000X
FLAL12174310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility