Provider Demographics
NPI:1487303582
Name:NORWOOD ASSISTED LIVING INC.
Entity type:Organization
Organization Name:NORWOOD ASSISTED LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:TUNGOL
Authorized Official - Last Name:WILKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-715-7845
Mailing Address - Street 1:325 NORWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4764
Mailing Address - Country:US
Mailing Address - Phone:321-459-0530
Mailing Address - Fax:321-459-0531
Practice Address - Street 1:325 NORWOOD ST
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4764
Practice Address - Country:US
Practice Address - Phone:321-459-0530
Practice Address - Fax:321-459-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility