Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
THE IDA HOUSE ASSISTED LIVING LLC
Active
Organization
THE IDA HOUSE ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRENIA BACALLAO RUIZ (PRESIDENT)
(813) 562-6135
Entity
Organization
Contact information
Practice address
6014 ROSEWOOD DR, TAMPA, FL 33615
(813) 562-6135
Mailing address
6014 ROSEWOOD DR, TAMPA, FL 33615-3428
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
13170
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024909900
—
FL
Enumeration date
10/17/2017
Last updated
03/06/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up