EXTENDED CARE PORTFOLIO TENANT, LLC
NPI: 1912330424
· TALLAHASSEE, FL 32303
· Assisted Living Facility
· NPI assigned 08/20/2013
$194K
Total Medicaid Paid
Provider Details
| Authorized Official | EDWARDS, TERESA (MANAGER) |
| NPI Enumeration Date | 08/20/2013 |
Related Entities
Other providers sharing the same authorized official: EDWARDS, TERESA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
| 2022 |
156 |
$147K |
| 2023 |
141 |
$46K |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
| T2030 |
Assisted living, waiver; per month |
297 |
252 |
$194K |