Provider Demographics
NPI:1891365086
Name:UNBIZ LLC
Entity Type:Organization
Organization Name:UNBIZ LLC
Other - Org Name:ST CLOUD HAVEN ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-800-8699
Mailing Address - Street 1:20009 OAKFLOWER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3647
Mailing Address - Country:US
Mailing Address - Phone:904-800-8699
Mailing Address - Fax:813-315-9860
Practice Address - Street 1:907 N TAYLOR RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-3121
Practice Address - Country:US
Practice Address - Phone:904-800-8699
Practice Address - Fax:813-315-9860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL111062600Medicaid