Organization
HIDDEN PINES ASSISTED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE MEDINA (OWNDER/ADMINISTRATOR)
(352) 854-7171
Entity
Organization
Contact information
Practice address
1840 SW 31ST AVENUE, OCALA, FL 34474
(352) 854-7171
(352) 854-1981
Mailing address
1840 SW 31ST AVENUE, OCALA, FL 34474
(352) 854-7171
(352) 854-1981
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5055
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140415600
—
FL
Enumeration date
09/24/2010
Last updated
09/24/2010
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