Provider Demographics
NPI:1841594173
Name:SAND POINT SENIOR LIVING
Entity type:Organization
Organization Name:SAND POINT SENIOR LIVING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SALES & MARKETING
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERAGINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-383-6000
Mailing Address - Street 1:1800 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-4695
Mailing Address - Country:US
Mailing Address - Phone:321-383-6000
Mailing Address - Fax:321-267-6308
Practice Address - Street 1:1800 HARRISON ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-4695
Practice Address - Country:US
Practice Address - Phone:321-383-6000
Practice Address - Fax:321-267-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 253Z00000X, 310400000X
FLAL5758261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy