Provider Demographics
NPI:1871863787
Name:KAPAALI HOLDINGS LLC
Entity Type:Organization
Organization Name:KAPAALI HOLDINGS LLC
Other - Org Name:CITRUS INN HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AVINASH
Authorized Official - Middle Name:W
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-401-8211
Mailing Address - Street 1:2275 8TH ST NW
Mailing Address - Street 2:SUITE #114
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-1331
Mailing Address - Country:US
Mailing Address - Phone:863-401-8211
Mailing Address - Fax:863-292-9297
Practice Address - Street 1:2275 8TH ST NW
Practice Address - Street 2:SUITE #114
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-1331
Practice Address - Country:US
Practice Address - Phone:863-401-8211
Practice Address - Fax:863-292-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12108310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility