Provider Demographics
NPI:1992014914
Name:PK ASSOCIATES INC.
Entity Type:Organization
Organization Name:PK ASSOCIATES INC.
Other - Org Name:PERFECT KARE ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALTON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-873-0325
Mailing Address - Street 1:5902 NW WOLVERINE RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3650
Mailing Address - Country:US
Mailing Address - Phone:772-873-0325
Mailing Address - Fax:772-336-9505
Practice Address - Street 1:5902 NW WOLVERINE RD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3650
Practice Address - Country:US
Practice Address - Phone:772-873-0325
Practice Address - Fax:772-336-9505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PK ASSOCIATES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11349310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002134600Medicaid