Provider Demographics
NPI:1750199378
Name:ORANGE GROVE APARTMENTS LLC
Entity type:Organization
Organization Name:ORANGE GROVE APARTMENTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:321-437-3550
Mailing Address - Street 1:8 W ORANGE ST # 101
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-4139
Mailing Address - Country:US
Mailing Address - Phone:321-437-3550
Mailing Address - Fax:
Practice Address - Street 1:8 W ORANGE ST # 101
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-4139
Practice Address - Country:US
Practice Address - Phone:321-437-3550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities