Provider Demographics
NPI:1720331028
Name:ERICA'S EQUITIES INC.
Entity Type:Organization
Organization Name:ERICA'S EQUITIES INC.
Other - Org Name:CROWN COURT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-344-5555
Mailing Address - Street 1:109 N SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34450-4148
Mailing Address - Country:US
Mailing Address - Phone:352-344-5555
Mailing Address - Fax:352-746-4040
Practice Address - Street 1:109 N. SEMINOLE AVE.
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34450
Practice Address - Country:US
Practice Address - Phone:352-344-5555
Practice Address - Fax:352-746-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL1058310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility