Organization
HAMPTON 24TH ROAD ALF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDER JOHNSEN (CEO)
(352) 387-1830
Entity
Organization
Contact information
Practice address
1500 SE 24TH RD, OCALA, FL 34471-6006
(352) 732-1122
(352) 433-0728
Mailing address
1740 SE 18TH ST STE 902, OCALA, FL 34471-5445
(352) 387-1830
(352) 433-0728
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114712600
—
FL
Enumeration date
07/14/2022
Last updated
07/14/2022
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