Provider Demographics
NPI:1154568368
Name:JULIES RETIREMENT RESORT 4
Entity type:Organization
Organization Name:JULIES RETIREMENT RESORT 4
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RADIKA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-832-4567
Mailing Address - Street 1:7006 HIAWASSEE OAK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8354
Mailing Address - Country:US
Mailing Address - Phone:407-832-4567
Mailing Address - Fax:
Practice Address - Street 1:7006 HIAWASSEE OAK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-8354
Practice Address - Country:US
Practice Address - Phone:407-832-4567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility