Provider Demographics
NPI:1912728759
Name:IONIE'S ASSISTED LIVING II LLC
Entity type:Organization
Organization Name:IONIE'S ASSISTED LIVING II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:PENNANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-296-7163
Mailing Address - Street 1:3120 HAMMERSMITH RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3073
Mailing Address - Country:US
Mailing Address - Phone:407-296-7163
Mailing Address - Fax:866-768-4105
Practice Address - Street 1:3120 HAMMERSMITH RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3073
Practice Address - Country:US
Practice Address - Phone:407-296-7163
Practice Address - Fax:866-768-4105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care