Fairgreen Assisted Living Inc.

LBN: Fairgreen Assisted Living Inc.
Fairgreen Assisted Living Inc. is an health care organization with primary practice located at 1150 Wayne Ave. , New Smyrna Beach FL 32168. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Fairgreen Assisted Living Inc. can be contacted via phone (386) 428-3018, or through Kepler, Jesusa H. via phone (386) 428-3018.

Contact Information

Primary practice address
1150 Wayne Ave. New Smyrna Beach FL 32168
Phone: (386) 428-3018
Fax: (386) 428-7485
Website:
Map and Directions
Authorized official contact:
Name: Kepler, Jesusa H. Registered Nurse (RN)
Phone: (386) 428-3018

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X AL11072 Florida

Profile Details

NPI number 1184059750
LBN Legal business name Fairgreen Assisted Living Inc.
DBA Doing business as
Authorized official Kepler, Jesusa H. Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 13th, 2013
Last updated Sep 13th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184059750 NPPES
Florida MEDICAID 1150

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