Provider Demographics
NPI:1831535616
Name:GUYCO SENIOR LIVING CONCEPTS
Entity type:Organization
Organization Name:GUYCO SENIOR LIVING CONCEPTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-302-6280
Mailing Address - Street 1:1600 NEPTUNE DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-5611
Mailing Address - Country:US
Mailing Address - Phone:321-302-6280
Mailing Address - Fax:321-327-9645
Practice Address - Street 1:2400 NEW YORK ST
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-6230
Practice Address - Country:US
Practice Address - Phone:321-473-8471
Practice Address - Fax:407-777-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12001310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility