Organization
NEW ORLEANS AVE, LLC
Active
Other names
Pinecrest Place
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN VILLANUEVA (OWNER)
(813) 563-3070
Entity
Organization
Contact information
Practice address
10637 LITHIA PINECREST RD, LITHIA, FL 33547-3222
(813) 737-2900
Mailing address
7983 CAMDEN WOODS DR, TAMPA, FL 33619-7000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104008900
—
FL
Enumeration date
11/26/2019
Last updated
12/09/2019
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