Provider Demographics
NPI:1902280407
Name:CURTIS GEORGE JR
Entity Type:Organization
Organization Name:CURTIS GEORGE JR
Other - Org Name:GEORGE PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:813-468-7384
Mailing Address - Street 1:24 FRESHWATER DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1106
Mailing Address - Country:US
Mailing Address - Phone:813-468-7384
Mailing Address - Fax:
Practice Address - Street 1:24 FRESHWATER DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1106
Practice Address - Country:US
Practice Address - Phone:813-468-7384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906767311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home