Organization · Type 2 NPI

Wickshire Port Orange Opco LLC

Assisted Living Facility · Port Orange, FL

NPI number 1023616943 Active

Practice location

1675 Dunlawton Ave
Port Orange, FL 32127-4755

Call (386) 761-1055 Map

Mailing address

750 Old Hickory Blvd
Brentwood, TN 37027-4528

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed
Alzheimer Center (Dementia Center) 311500000XNone listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

13 other providers at this address

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About NPI 1023616943

Wickshire Port Orange Opco LLC's National Provider Identifier is 1023616943, issued on Oct 13, 2020. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Port Orange, FL. The record was last updated on Oct 13, 2020.