Provider Demographics
NPI:1154981504
Name:NF NINE MILE, LLC
Entity type:Organization
Organization Name:NF NINE MILE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-430-0000
Mailing Address - Street 1:40 PALAFOX PL STE 400
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5699
Mailing Address - Country:US
Mailing Address - Phone:850-430-0000
Mailing Address - Fax:
Practice Address - Street 1:9310 FOWLER AVENUE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534
Practice Address - Country:US
Practice Address - Phone:850-430-0600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GULF COAST FACILITIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-18
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility