Organization
MCINTOSH ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY ROBINSON (OWNER)
(352) 591-2503
Entity
Organization
Contact information
Practice address
5650 NW 219TH STREET RD, MICANOPY, FL 32667-7948
(352) 591-2503
Mailing address
5650 NW 219TH STREET RD, MICANOPY, FL 32667-7948
(352) 591-2503
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AL10451
FL
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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