Nic 4 Bayside Terrace Leasing LLC
NPI #1528402229 in Pinellas Park, Florida
Provider Information
- NPI Number
- 1528402229
- Entity Type
- Organization
- Organization Name
- Nic 4 Bayside Terrace Leasing LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Apr 24, 2013
- Last Updated
- Dec 8, 2016
Practice Location
- Address
- 9381 U.S. 19
- City
- Pinellas Park
- State
- Florida
- ZIP Code
- 33782
- Phone
- (727) 576-1234
Authorized Official
- Name
- JANE RYU
- Title
- PRESIDENT/CEO/CFO
- Phone
- (212) 479-5270
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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