McIntosh Assisted Living
Health Maintenance Organization in Micanopy, FL. Organization (NPI-2).
NPI number1154771905
StatusActive
Last updated in NPPESJun 13, 2016
Details
- NPI
- 1154771905
- Entity type
- Organization (NPI-2)
- Legal business name
- McIntosh Assisted Living
- Organization subpart
- No
- Enumeration date
- Jun 13, 2016
- Last updated
- Jun 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302R00000X | Health Maintenance Organization | AL10451 | FL | Yes |
Practice location
5650 Nw 219th Street RdMicanopy, FL 32667-7948
Phone 352-591-2503
Mailing address
5650 Nw 219th Street RdMicanopy, FL 32667-7948
Phone 352-591-2503
Authorized official
Dorothy Robinson
Owner
3525912503
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