Provider Demographics
NPI:1740818475
Name:ALBA COURT DEVELOPMENT GROUP, LLC
Entity type:Organization
Organization Name:ALBA COURT DEVELOPMENT GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RYLANDA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:386-349-1515
Mailing Address - Street 1:5208 ALTON RD REAR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2005
Mailing Address - Country:US
Mailing Address - Phone:305-968-2402
Mailing Address - Fax:
Practice Address - Street 1:115 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA
Practice Address - State:FL
Practice Address - Zip Code:32168-7068
Practice Address - Country:US
Practice Address - Phone:305-864-4248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)