Basic Information
| Provider Information | |||||||||
| NPI: | 1548934961 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PADDOCK RIDGE ASSISTED LIVING FACILITY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 WEST ST | ||||||||
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| City: | WILMINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018873039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812550531 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4001 SW 33RD CT | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344746296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812550531 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2021 | ||||||||
| LastUpdateDate: | 08/09/2021 | ||||||||
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| AuthorizedOfficialLastName: | LABELLA | ||||||||
| AuthorizedOfficialFirstName: | CATERINA | ||||||||
| AuthorizedOfficialMiddleName: | MINA | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5089049139 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.