FS TENANT POOL IV TRUST
NPI: 1245256700
· FORT MYERS, FL 33907
· Assisted Living Facility
· NPI assigned 07/15/2006
$142K
Total Medicaid Paid
Provider Details
| Authorized Official | POTTER, KATHERINE (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Parent Organization | FS TENANT POOL IV TRUST |
| NPI Enumeration Date | 07/15/2006 |
Related Entities
Other providers sharing the same authorized official: POTTER, KATHERINE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2018 |
167 |
$106K |
| 2019 |
385 |
$35K |
| 2020 |
564 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| T2030 |
Assisted living, waiver; per month |
1,116 |
593 |
$142K |