Provider Demographics
NPI:1922714310
Name:PEARLS CARE ASSISTED LIVING FACILITY, LLC
Entity Type:Organization
Organization Name:PEARLS CARE ASSISTED LIVING FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAING
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:908-568-9751
Mailing Address - Street 1:384 VENTURA DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-4600
Mailing Address - Country:US
Mailing Address - Phone:908-568-9751
Mailing Address - Fax:
Practice Address - Street 1:10215 WILLOW DR
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-3349
Practice Address - Country:US
Practice Address - Phone:908-568-9751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility