NPI 1164192316

Indian River Paradise LLC

Organisation Assisted Living Facility Merritt Island, FL

Practice location

Address: 1275 N Banana River Dr, Merritt Island, FL 32952-5757
Phone: (914) 373-8098
Mailing address: 2721 SE North Lookout Blvd, Port Saint Lucie, FL 34984-6108

Authorised official

Name: Mostafa S Hassan
Title: President
Phone: (914) 373-8098

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1164192316
Entity type: Organization
NPI issued: 19 Sep 2021
Record last updated: 19 Sep 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.