NPI: 1336536754 · ORMOND BEACH, FL 32174 · Assisted Living Facility · NPI assigned 04/23/2015
| Authorized Official | SHARON, SHOSHANA (OWNER) |
| NPI Enumeration Date | 04/23/2015 |
Other providers sharing the same authorized official: SHARON, SHOSHANA
| Provider | City | State | Total Paid |
|---|---|---|---|
| 1001 OLD TOMOKA LLC | ORMOND BEACH | FL | $19K |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 178 | $171K |
| 2023 | 231 | $253K |
| 2024 | 185 | $277K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2030 | Assisted living, waiver; per month | 594 | 509 | $701K |