Provider Demographics
NPI:1114719820
Name:CAPE CORAL ASSISTED LIVING FACILITY SOUTH LLC
Entity type:Organization
Organization Name:CAPE CORAL ASSISTED LIVING FACILITY SOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:238-888-1809
Mailing Address - Street 1:601 SE 14TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 SE 14TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2133
Practice Address - Country:US
Practice Address - Phone:239-888-1809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility