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Organization

GV-ORMOND, LLC

Active
Other names
Grand Villa of Ormond Beach
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DENNIS FORTE (MANAGER)
(727) 726-3980
Entity
Organization

Contact information

Practice address
535 N NOVA RD, ORMOND BEACH, FL 32174-4405
(386) 673-5000
(386) 673-0168
Mailing address
13770 58TH ST N, SUITE 312, CLEARWATER, FL 33760-3759
(727) 726-3980
(727) 726-5345

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7460
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000592000
FL
Enumeration date
04/04/2013
Last updated
04/04/2013
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