Provider Demographics
NPI:1801870712
Name:VENICE NH, LLC
Entity type:Organization
Organization Name:VENICE NH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-557-6200
Mailing Address - Street 1:832 SUNSET LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-7550
Mailing Address - Country:US
Mailing Address - Phone:941-492-5313
Mailing Address - Fax:941-492-5315
Practice Address - Street 1:832 SUNSET LAKE BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7550
Practice Address - Country:US
Practice Address - Phone:941-492-5313
Practice Address - Fax:941-492-5315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-05
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X
FLSNF15720961314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL030850100Medicaid
FL5610200001Medicare NSC
FL105761Medicare Oscar/Certification