Provider Demographics
NPI:1912267824
Name:NOMEL'S ASSISTED LIVING
Entity type:Organization
Organization Name:NOMEL'S ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:IONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-458-0840
Mailing Address - Street 1:3818 JUPITER BLVD SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-3872
Mailing Address - Country:US
Mailing Address - Phone:321-984-4265
Mailing Address - Fax:321-729-6531
Practice Address - Street 1:3818 JUPITER BLVD SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-3872
Practice Address - Country:US
Practice Address - Phone:321-984-4265
Practice Address - Fax:321-729-6531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11834310400000X
FL11305310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility