Provider Demographics
NPI:1720323587
Name:CAPE CHATEAU INC
Entity Type:Organization
Organization Name:CAPE CHATEAU INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GNOLFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-218-6190
Mailing Address - Street 1:804 SE 16TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1645
Mailing Address - Country:US
Mailing Address - Phone:239-218-6190
Mailing Address - Fax:239-574-8436
Practice Address - Street 1:804 SE 16TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1645
Practice Address - Country:US
Practice Address - Phone:239-218-6190
Practice Address - Fax:239-574-8436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8573310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004030900Medicaid
FL1425064000OtherACS