Provider Demographics
NPI:1700616513
Name:VENICE AL OPCO LLC
Entity type:Organization
Organization Name:VENICE AL OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-737-6669
Mailing Address - Street 1:1637 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2902
Mailing Address - Country:US
Mailing Address - Phone:718-737-6669
Mailing Address - Fax:
Practice Address - Street 1:200 NASSAU ST N
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-1772
Practice Address - Country:US
Practice Address - Phone:718-360-8083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VVENICE VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility