NIC 4 THE GRANDE LEASING LLC (NPI# 1689018301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689018301 |
| Entity Type | Organization |
| Organization Name | NIC 4 THE GRANDE LEASING LLC |
| Other Organization Name | THE GRANDE |
| Practice Address |
725 Desoto Avenue Brooksville FL 34601 |
| Mailing Address |
Po Box 1700 C/o Holiday Retirement Nic 4 The Grande Leasing LLC Lake Oswego OR 97035 |
| Practice Telephone | 3525440944 |
| Mailing Telephone | 9712458020 |
| Mailing Fax Number | 5034312295 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2016-12-01 |
| Authorized Official Name | JANE RYU (PRESIDENT/CEO/CFO) |
| Authorized Official Telephone | 2124795270 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 11732 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Grande | Doing Business As Name - Organization |
| Street Address |
725 DESOTO AVENUE |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811526643 | Benzer Fl 39 LLC | Pharmacy | 80 Ponca De Leon Blvd, Brooksville, FL 34601 | 2020-04-03 |
| 1245868702 | Karon Elaine Stagg | Specialist/Technologist | 20158 Cortez Blvb, Brookesville, FL 34601 | 2020-03-31 |
| 1699253666 | Shedding Light Counseling 'llc' | Counselor | 24059 Cortez Blvd, Brooksville, FL 34601 | 2018-08-01 |
| 1265952162 | Tysheeca Deandrea Washington | Assistant Behavior Analyst | 1535 Greenbriar Villa Circle, Brooksville, FL 34601 | 2017-06-21 |
| 1386179836 | Andrew Bishay | Emergency Medical Technician, Intermediate | 7284 Broad St, Brooksville, FL 34601 | 2017-04-21 |
| 1265892152 | Ralph Vitola | Pharmacist | 218 S. Broad St., Brooksville, FL 34601 | 2016-03-04 |
| 1023301496 | Gerald Warren Springstead | Dentist | 605 W. Jefferson St., Brooksville, FL 34601 | 2011-05-18 |
| 1417280330 | Growing Center Counseling | Counselor | 275 W. Jefferson St., Brooksville, FL 34601 | 2009-09-10 |
| 1073663118 | Jennifer Suiters | Social Worker | 706 Ponce De Leon Blvd, Brooksville, FL 34601 | 2007-01-11 |
| 1326114349 | Ernest A Brady Jr. | Dentist | 120 No Broad St Suite 102, Brooksville, FL 34601 | 2006-11-28 |
| Find all providers in zip 34601 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457720815 | Custom Care LLC | Assisted Living Facility | 6177 Ivy Hill Ln, Brooksville, FL 34602-7925 | 2015-09-16 |
| 1659719284 | Serenity House | Assisted Living Facility | 14355 Highgrove Rd, Brooksville, FL 34609-8605 | 2013-06-05 |
| 1356785745 | Nic 4 Spring Oaks Leasing LLC | Assisted Living Facility | 7251 Grove Road, Brooksville, FL 34613 | 2013-04-29 |
| 1326381021 | Turner Care Alf | Assisted Living Facility | 5483 Neff Lake Rd, Brooksville, FL 34601-7842 | 2013-04-01 |
| 1679740062 | Charlene Faye Curtis | Assisted Living Facility | 7433 Ray Browning Rd, Brooksville, FL 34601-3808 | 2008-05-14 |
| 1326267691 | Spring Oaks, LLC | Assisted Living Facility | 7251 Grove Rd, Brooksville, FL 34613-6083 | 2007-04-25 |
| 1992340624 | Nss-alf Brooksville LLC | Assisted Living Facility | 307 Howell Ave, Brooksville, FL 34601-2039 | 2019-11-18 |
| 1437663952 | Tangerine Cove Plc LLC | Assisted Living Facility | 307 Howell Ave, Brooksville, FL 34601-2039 | 2017-11-20 |
| 1922517184 | Gahc4 Spring Oaks Fl Trs Sub, LLC | Assisted Living Facility | 7251 Grove Rd, Brooksville, FL 34613-6083 | 2017-09-20 |
| 1598274755 | Gahc4 Grande Fl Trs Sub, LLC | Assisted Living Facility | 725 Desoto Ave, Brooksville, FL 34601-2813 | 2017-09-20 |
| Find all providers in BROOKSVILLE | ||||
| City | BROOKSVILLE |
| Zip Code | 34601 |
Please comment or provide details below to improve the information on NIC 4 THE GRANDE LEASING LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.