Provider Demographics
NPI:1881009462
Name:CLOISTERS RHF HOUSING, LLC
Entity Type:Organization
Organization Name:CLOISTERS RHF HOUSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:PEABODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-257-5100
Mailing Address - Street 1:400 E HOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-5400
Mailing Address - Country:US
Mailing Address - Phone:386-822-6900
Mailing Address - Fax:386-822-4152
Practice Address - Street 1:400 E HOWRY AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-5400
Practice Address - Country:US
Practice Address - Phone:386-822-6900
Practice Address - Fax:386-822-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8340310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility