Provider Demographics
NPI:1942720982
Name:CADIZ SENIOR CARE
Entity Type:Organization
Organization Name:CADIZ SENIOR CARE
Other - Org Name:FARRINGTON HOUSE ASSISTED LIVING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:CADIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-506-7181
Mailing Address - Street 1:1970 FARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-5532
Mailing Address - Country:US
Mailing Address - Phone:321-208-7955
Mailing Address - Fax:321-208-7956
Practice Address - Street 1:1970 FARRINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952
Practice Address - Country:US
Practice Address - Phone:321-208-7955
Practice Address - Fax:321-208-7956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11613310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility