NIC 4 VILLAGE PLACE LEASING LLC
NPI: 1811331283
· PORT CHARLOTTE, FL 33948
· Assisted Living Facility
· NPI assigned 04/29/2013
$244K
Total Medicaid Paid
Provider Details
| Authorized Official | RYU, JANE (PRESIDENT/CEO/CFO) |
| NPI Enumeration Date | 04/29/2013 |
Related Entities
Other providers sharing the same authorized official: RYU, JANE
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2019 |
197 |
$217K |
| 2020 |
30 |
$27K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2030 |
Assisted living, waiver; per month |
227 |
227 |
$244K |