Provider Demographics
NPI:1972183432
Name:TRIDENT ACQUISITION CONSULTANTS I, LLC
Entity Type:Organization
Organization Name:TRIDENT ACQUISITION CONSULTANTS I, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:DEFEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-249-3860
Mailing Address - Street 1:PO BOX 2378
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-2378
Mailing Address - Country:US
Mailing Address - Phone:561-249-3860
Mailing Address - Fax:561-813-6813
Practice Address - Street 1:3918 S KINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7749
Practice Address - Country:US
Practice Address - Phone:813-662-1535
Practice Address - Fax:813-681-3585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility