Provider Demographics
NPI:1386168359
Name:WESTMINSTER PINES, INC.
Entity type:Organization
Organization Name:WESTMINSTER PINES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. V.P. & CFO
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:T
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:407-839-5050
Mailing Address - Street 1:80 W LUCERNE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3779
Mailing Address - Country:US
Mailing Address - Phone:407-839-5050
Mailing Address - Fax:407-849-1718
Practice Address - Street 1:235 TOWERVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:ST. AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092
Practice Address - Country:US
Practice Address - Phone:904-940-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility