Provider Demographics
NPI:1063276673
Name:MARIGOLD CARE FACILITY LLC
Entity type:Organization
Organization Name:MARIGOLD CARE FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUVEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-724-4327
Mailing Address - Street 1:826 EVERGLADE AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-4439
Mailing Address - Country:US
Mailing Address - Phone:407-724-4327
Mailing Address - Fax:
Practice Address - Street 1:826 EVERGLADE AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-4439
Practice Address - Country:US
Practice Address - Phone:407-724-4327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker