Provider Demographics
NPI:1053884940
Name:ELLIE'S ALF OF OCALA
Entity type:Organization
Organization Name:ELLIE'S ALF OF OCALA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKBERSINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-881-3703
Mailing Address - Street 1:1840 SW 31ST AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-2904
Mailing Address - Country:US
Mailing Address - Phone:352-854-7171
Mailing Address - Fax:
Practice Address - Street 1:1840 SW 31ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-2904
Practice Address - Country:US
Practice Address - Phone:352-854-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness