Provider Demographics
NPI:1699146977
Name:ZION'S II ALF,INC DBA A BIDE N LOVE
Entity type:Organization
Organization Name:ZION'S II ALF,INC DBA A BIDE N LOVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERON
Authorized Official - Middle Name:
Authorized Official - Last Name:WHYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-327-2718
Mailing Address - Street 1:256 BARBAROSSA RD NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-1809
Mailing Address - Country:US
Mailing Address - Phone:321-327-2718
Mailing Address - Fax:321-499-4762
Practice Address - Street 1:2698 HESTER AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-7607
Practice Address - Country:US
Practice Address - Phone:321-327-2718
Practice Address - Fax:321-499-4762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZION'S LL ALF,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12731310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012221900Medicaid