Organization
NIC 4 VILLAGE PLACE LEASING LLC
Active
Other names
Village Place Retirement
Organization subpart
No
Provider details
NPI number
Authorized official
JANE RYU (PRESIDENT/CEO/CFO)
(212) 479-5270
Entity
Organization
Contact information
Practice address
18400 COCHRAN BLVD., PORT CHARLOTTE, FL 33948
(941) 766-8900
(941) 766-8224
Mailing address
PO BOX 1700 C/O HOLIDAY RETIREMENT, NIC 4 VILLAGE PLACE LEASING LLC, LAKE OSWEGO, OR 97035
(971) 245-8020
(503) 431-2295
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9249
FL
Other
Enumeration date
04/29/2013
Last updated
11/22/2016
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