Nic 5 Spring Haven Leasing LLC
NPI #1992149397 in Winter Haven, Florida
Provider Information
- NPI Number
- 1992149397
- Entity Type
- Organization
- Organization Name
- Nic 5 Spring Haven Leasing LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Apr 29, 2013
- Last Updated
- Dec 1, 2016
Practice Location
- Address
- 1225 NW HAVENDALE BOULEVARD
- City
- Winter Haven
- State
- Florida
- ZIP Code
- 33881
- Phone
- (863) 293-0072
Authorized Official
- Name
- JANE RYU
- Title
- PRESIDENT/CEO/CFO
- Phone
- (212) 479-5270
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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