Provider Demographics
NPI:1811230808
Name:HPLS ASSISTED LIVING INC
Entity Type:Organization
Organization Name:HPLS ASSISTED LIVING INC
Other - Org Name:MAGNOLIA HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:HAZEL
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:407-383-7071
Mailing Address - Street 1:300 E KALEY ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-3028
Mailing Address - Country:US
Mailing Address - Phone:407-843-3441
Mailing Address - Fax:
Practice Address - Street 1:300 E KALEY ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-3028
Practice Address - Country:US
Practice Address - Phone:407-843-3441
Practice Address - Fax:407-843-3442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL5886310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility