Provider Demographics
NPI:1912434648
Name:ALCIME PROFESSIONAL CARE LLC
Entity Type:Organization
Organization Name:ALCIME PROFESSIONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN-CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCIME
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:603-231-9263
Mailing Address - Street 1:2419 SW SANSOM LN
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2680
Mailing Address - Country:US
Mailing Address - Phone:603-231-9263
Mailing Address - Fax:877-310-8660
Practice Address - Street 1:2419 SW SANSOM LN
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2680
Practice Address - Country:US
Practice Address - Phone:603-231-9263
Practice Address - Fax:877-310-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility