NPI: 1538580923 · ORMOND BEACH, FL 32174 · Assisted Living Facility · NPI assigned 01/02/2014
| Authorized Official | SHARON, SHOSHANA (ADMINISTRATOR) |
| NPI Enumeration Date | 01/02/2014 |
Other providers sharing the same authorized official: SHARON, SHOSHANA
| Provider | City | State | Total Paid |
|---|---|---|---|
| 30 FOREST CT, LLC | ORMOND BEACH | FL | $701K |
| Year | Claims | Total Paid |
|---|---|---|
| 2024 | 16 | $19K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2030 | Assisted living, waiver; per month | 16 | 12 | $19K |