Provider Demographics
NPI:1639512502
Name:JEM'STENDER HEART CARE INC
Entity Type:Organization
Organization Name:JEM'STENDER HEART CARE INC
Other - Org Name:PLEASANTVILLE ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:R
Authorized Official - Last Name:OCAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-383-3140
Mailing Address - Street 1:609 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757
Mailing Address - Country:US
Mailing Address - Phone:352-383-3140
Mailing Address - Fax:352-383-3170
Practice Address - Street 1:609 OAK AVE
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6039
Practice Address - Country:US
Practice Address - Phone:352-383-3140
Practice Address - Fax:352-383-3170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL7968310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility