Basic Information
| Provider Information | |||||||||
| NPI: | 1821486713 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HILLS-CITRUS HOLDINGS OF LECANTO LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 279 N LECANTO HWY | ||||||||
| Address2: | |||||||||
| City: | LECANTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344619195 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 279 N LECANTO HWY | ||||||||
| Address2: | |||||||||
| City: | LECANTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344619195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525279720 | ||||||||
| FaxNumber: | 3527466662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2014 | ||||||||
| LastUpdateDate: | 12/31/2014 | ||||||||
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| AuthorizedOfficialLastName: | MUELLER | ||||||||
| AuthorizedOfficialFirstName: | GEORGE | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | REGISTERED AGENT | ||||||||
| AuthorizedOfficialTelephone: | 3525279720 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | AL9126 | FL | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.