NIC 5 SPRING HAVEN LEASING LLC


Address: 1225 Nw Havendale Boulevard, Winter Haven, FL 33881
Phone: 8632930072

NIC 5 SPRING HAVEN LEASING LLC (NPI# 1992149397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992149397
Entity Type Organization
Organization Name NIC 5 SPRING HAVEN LEASING LLC
Other Organization Name SPRING HAVEN RETIREMENT COMMUNITY
Practice Address 1225 Nw Havendale Boulevard
Winter Haven
FL 33881
Mailing Address Po Box 1700, Nic 5 Spring Haven Leasing LLC
C/o Holiday Retirement
Lake Oswego
OR 97035
Practice Telephone 8632930072
Practice Fax Number 8632944935
Mailing Telephone 9712458020
Mailing Fax Number 5034312295
Enumeration Date 2013-04-29
Last Update Date 2016-12-01
Authorized Official Name JANE RYU (PRESIDENT/CEO/CFO)
Authorized Official Telephone 2124795270
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 310400000X Assisted Living Facility 5504 FL Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
Spring Haven Retirement Community Doing Business As Name - Organization

Office Location

Street Address 1225 NW HAVENDALE BOULEVARD
City WINTER HAVEN
State FL
Zip Code 33881

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114534476 Ctc's Heart of Caring, Inc In Home Supportive Care 2995 Eagle Nest View Drive, Winter Haven, FL 33881 2020-09-29
1356813869 Michael Thomas Wiernicki Dentist 1074 Spring Lake Plaza, Winter Haven, FL 33881 2018-12-21
1659862423 Patricia Pelt Social Worker 3073 Buckeye Point Dr, Winter Haven, FL 33881 2018-05-28
1952891244 Ansley Health LLC Home Health 1502 6th Ct Ne, Winter Haven, FL 33881 2018-05-14
1346699261 Yovanka Zapata Specialist/Technologist, Other 5856 Windrigde Dr., Winter Haven, FL 33881 2016-06-10
1720415599 Villa Pharmacy LLC Pharmacy 105 Avenue R Nw, Winter Haven, FL 33881 2013-10-10
1780938225 Penelope Sturdevant Nurse Practitioner 2791 Lake Alfred Rd., Winter Haven, FL 33881 2012-11-06
1649548165 Tim R Acree Non-emergency Medical Transport (VAN) 2 Eagles Nest, Winter Haven, FL 33881 2011-12-12
1285899419 Adjustment and Awareness Counseling Community/Behavioral Health 243 3rd St Nw, Winter Haven, FL 33881 2008-07-28
1245491091 Mid-florida Ob Gyn Hospitalist Physician Services L L C Obstetrics & Gynecology 101 Avenue O Ne, Winter Haven, FL 33881 2008-06-24
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Taxonomy Information

Taxonomy Code 310400000X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245761162 Melissa Davis Assisted Living Facility 4364 Diamond Rd, Winter Haven, FL 33880-1502 2017-03-22
1336688258 Ambitious Quality Care Assisted Living Assisted Living Facility 3939 Country Pl Apt C, Winter Haven, FL 33880-1519 2017-02-13
1023424405 Autumn Breeze Assisted Living Facility Inc Assisted Living Facility 904 Lake Martha Dr Ne, Winter Haven, FL 33881-4278 2014-07-07
1871863787 Kapaali Holdings LLC Assisted Living Facility 2275 8th St Nw, Suite #114, Winter Haven, FL 33881-1331 2012-01-09
1730474420 Successful Ambitions Assisted Living Facility 3939 Country Place Unit C, Winter Haven, FL 33880 2011-06-10
1972805364 Brookdale Senior Living Communities, Inc. Assisted Living Facility 6110 Cypress Gardens Blvd, Winter Haven, FL 33884-4150 2010-11-17
1366603243 Liberty Assisted Living Assisted Living Facility 5890 Cypress Gardens Blvd, Winter Haven, FL 33884-2274 2008-06-23
1891910337 Omnia Cum Deo Corp Assisted Living Facility 2100 State Road 540 W, Winter Haven, FL 33880-1768 2007-04-17
1851998256 Miss K's Enrichment Center Inc Dba Campbell's Landing Assisted Living Assisted Living Facility 904 Lake Martha Dr Ne, Winter Haven, FL 33881-4278 2020-10-08
1215591144 Sh Lake Howard, LLC Assisted Living Facility 650 N Lake Howard Dr, Winter Haven, FL 33881-3162 2019-04-25
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Competitor

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City WINTER HAVEN
Zip Code 33881

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Dataset Information

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.

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