Provider Demographics
NPI:1831620368
Name:BLACK RING CAPITAL INVESTMENTS LLC
Entity type:Organization
Organization Name:BLACK RING CAPITAL INVESTMENTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:KORNEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, JD, MBA
Authorized Official - Phone:407-951-0268
Mailing Address - Street 1:3895 BISCAYNE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4628
Mailing Address - Country:US
Mailing Address - Phone:407-951-0268
Mailing Address - Fax:407-264-8660
Practice Address - Street 1:700 E WELCH RD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2921
Practice Address - Country:US
Practice Address - Phone:407-880-8020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-26
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12479310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility