National Provider Identifier Database

NIC 4 BAYSIDE TERRACE LEASING LLC
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.


Contact Information

NIC 4 BAYSIDE TERRACE LEASING LLC
9381 U.S. 19
PINELLAS PARK, FL33782
Phone: 727-576-1234
Fax: 727-570-2257
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for NIC 4 BAYSIDE TERRACE LEASING LLC

NPI Number 1528402229
Legal business name
LBN
NIC 4 BAYSIDE TERRACE LEASING LLC
Authorized official JANE RYU - (PRESIDENT/CEO/CFO)
Entity Organization
Organization subpart No
Enumeration date 04/24/2013
Last updated 12/08/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: 6139
  • FL Other: 004295900 MEDICAID AL WAIVER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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