NPI Provider: 1477558039
Contact Name: Mando William
Position: CFO
Phone: (813) 635-9500
Ridgecrest Nh, Llc Information:
Ridgecrest Nh, Llc organization have npi 1477558039, taxonomy code is 314000000X with license number is SNF1475096 in . This Business address located in 1200 N Stone St, Deland, FL 32720 Florida.
Practice Location
Address: 1200 N Stone St, Deland, FL 32720
Phone: (386) 734-4334
Business Location
Address: 1200 N Stone St, Deland, FL 32720
Phone: (386) 734-4334
Fax: (386) 736-2118
Taxonomy
Taxonomy Code: 314000000X
License Number: SNF1475096
License Number of State: FL
Primary Taxonomy Switch: Y
Enumeration Date: 6/20/2005
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