Provider Demographics
NPI:1740254911
Name:LARGO INVESTMENTS AND ASSOCIATES LLC
Entity type:Organization
Organization Name:LARGO INVESTMENTS AND ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-581-9427
Mailing Address - Street 1:3500 OAK MANOR LN
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-1211
Mailing Address - Country:US
Mailing Address - Phone:727-581-9427
Mailing Address - Fax:727-489-0856
Practice Address - Street 1:3500 OAK MANOR LN
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-1211
Practice Address - Country:US
Practice Address - Phone:727-581-9427
Practice Address - Fax:727-489-0856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL7150310400000X
FLSNF1376096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK03OtherBCBS
FL141864500Medicaid
FL025834200Medicaid
FL141864500Medicaid
FL025834200Medicaid