MG PORT CHARLOTTE I SUBTENANT LLC
NPI: 1487282349
· PORT CHARLOTTE, FL 33952
· Assisted Living Facility
· NPI assigned 03/27/2020
$412K
Total Medicaid Paid
Provider Details
| Authorized Official | SPEAR, DOUGLAS (AUTHORIZED REPRESENTATIVE) |
| NPI Enumeration Date | 03/27/2020 |
Related Entities
Other providers sharing the same authorized official: SPEAR, DOUGLAS
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2020 |
326 |
$317K |
| 2021 |
112 |
$95K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| T2030 |
Assisted living, waiver; per month |
438 |
363 |
$412K |