NIC 4 BALMORAL LEASING LLC (NPI# 1720422405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720422405 |
| Entity Type | Organization |
| Organization Name | NIC 4 BALMORAL LEASING LLC |
| Other Organization Name | BALMORAL ASSISTED LIVING |
| Practice Address |
93 Balmoral Drive Lake Placid FL 33852 |
| Mailing Address |
Po Box 1700, Nic 4 Balmoral Leasing LLC C/o Holiday Retirement Lake Oswego OR 97035 |
| Practice Telephone | 8634656584 |
| Practice Fax Number | 8634656585 |
| Mailing Telephone | 9712458020 |
| Mailing Fax Number | 5034312296 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2016-11-30 |
| 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 | 11307 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAID AL WAIVER | 003688600 | 01 |
| Other Name | Type Code |
|---|---|
| Balmoral Assisted Living | Doing Business As Name - Organization |
| Street Address |
93 BALMORAL DRIVE |
| City | LAKE PLACID |
| State | FL |
| Zip Code | 33852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728763 | Eduardo Enrique Florez | Behavior Technician | 621 S Sun N Lakes Blvd, Lake Placid, FL 33852 | 2018-07-30 |
| 1841738051 | Halcyon Rehabilitation, LLC | Clinic/Center | 1297 Us-27, Lake Placid, FL 33852 | 2017-02-08 |
| 1386014009 | Randolph Giller | Hearing Instrument Specialist | 403 E. Interlake Blvd., Lake Placid, FL 33852 | 2015-10-07 |
| 1275918369 | Toyeca Robinson | Technician, Other | 448 Lake Gloria Dr, Lake Placid, FL 33852 | 2015-07-30 |
| 1720036908 | Stephanie Delbert | Nurse Practitioner | 13 N Main Ave, Lake Placid, FL 33852 | 2006-05-04 |
| 1821084013 | Eladio Lao | Anesthesiology | 1012 Hwy 27 N, Lake Placid, FL 33852 | 2005-09-22 |
| 1699204693 | Stephaniedelbert,arnp,inc | Nurse Practitioner | 13 N Main Ave, Lake Placid, FL 33852 | 2017-06-05 |
| 1639228398 | James Edward Oxer | Dentist | 408 W Interlake Blvd, Lake Placid, FL 33852-0700 | 2007-01-10 |
| 1093293847 | Thomas Veronee | Dentist | 408 W Interlake Blvd, Lake Placid, FL 33852-0700 | 2018-08-03 |
| 1205046810 | Sunshine Family Dentistry | Dentist | 408 W Interlake Blvd, Lake Placid, FL 33852-0700 | 2007-05-23 |
| Find all providers in zip 33852 | ||||
| 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 |
|---|---|---|---|---|
| 1962760108 | Balmoral Assisted Living, LLC | Assisted Living Facility | 93 Balmoral Dr, Lake Placid, FL 33852-7000 | 2012-04-25 |
| 1750800959 | Gahc4 Balmoral Fl Trs Sub, LLC | Assisted Living Facility | 93 Balmoral Dr, Lake Placid, FL 33852-7000 | 2017-09-19 |
| 1629400379 | Sf Lake Placid Alf, LLC | Assisted Living Facility | 1297 Us 27 N, Lake Placid, FL 33852-7907 | 2013-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275372 | Loving Family Senior Care, LLC | Assisted Living Facility | 2323 Nw 34th St, Miami, FL 33142-5307 | 2020-11-08 |
| 1548861230 | Allure A&l Inc | Assisted Living Facility | 13692 Carlton St, Wellington, FL 33414-7748 | 2020-11-08 |
| 1982205787 | Pd & Sr, L.L.C. | Assisted Living Facility | 730 Frisco St Se, Palm Bay, FL 32909-3711 | 2020-11-06 |
| 1982205019 | Cantillo Love & Care LLC | Assisted Living Facility | 1045 W 23rd St, Hialeah, FL 33010-1922 | 2020-11-04 |
| 1194326728 | Bliss Life Residential Care | Assisted Living Facility | 402 Arthur Ave, Lehigh Acres, FL 33936-7412 | 2020-11-02 |
| 1811597404 | Huguette Mortimer Dupont | Assisted Living Facility | 1596 Sw Paar Dr, Port St Lucie, FL 34953-6159 | 2020-11-01 |
| 1750981841 | Senior Living Properties IIi, LLC | Assisted Living Facility | 3791 Old Canoe Creek Rd, Saint Cloud, FL 34769-6630 | 2020-10-28 |
| 1417556028 | 5081 Cambridge LLC | Assisted Living Facility | 5081 Nw Dunn Rd, Fort Pierce, FL 34981-4942 | 2020-10-23 |
| 1134728926 | Pacifica Lauderhill LLC | Assisted Living Facility | 5500 Nw 69th Ave, Lauderhill, FL 33319-7266 | 2020-10-22 |
| 1760081749 | Hsre-ahr Zephyrhills LLC | Assisted Living Facility | 38130 Pretty Pond Road, Zephyrhills, FL 33540 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | LAKE PLACID |
| Zip Code | 33852 |
Please comment or provide details below to improve the information on NIC 4 BALMORAL 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.