Provider Demographics
NPI:1609214790
Name:PLEASANT RETIREMENT HOME,INC
Entity Type:Organization
Organization Name:PLEASANT RETIREMENT HOME,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-540-8563
Mailing Address - Street 1:7512 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-5312
Mailing Address - Country:US
Mailing Address - Phone:561-540-8563
Mailing Address - Fax:561-540-8563
Practice Address - Street 1:7512 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-5312
Practice Address - Country:US
Practice Address - Phone:561-540-8563
Practice Address - Fax:561-540-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10188310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherASSISTED LIVING FACILITY