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SUMMERVILLE 16, LLC

Alzheimer Center

Jensen Beach, Florida

Provider NPI: 1447427703

Organization Information:
Organization Name:  SUMMERVILLE 16, LLC


Practice Location:
1700 NE INDIAN RIVER DR  JENSEN BEACH, FL 34957 US
Tel: 772-225-1355  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
FLAL9294
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
FLAL9294

Other Provider Identifiers:

IssuerNumberStateType
0118952-00FL05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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