Provider Demographics
NPI:1629800404
Name:HUMMINGBIRD SENIOR RESORT LIVING LLC
Entity type:Organization
Organization Name:HUMMINGBIRD SENIOR RESORT LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PRASHANT
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-428-6479
Mailing Address - Street 1:5 DANA LN
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-2706
Mailing Address - Country:US
Mailing Address - Phone:631-428-6479
Mailing Address - Fax:
Practice Address - Street 1:2047 S HIGHWAY 92
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-5854
Practice Address - Country:US
Practice Address - Phone:520-458-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility