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SUMMERVILLE 3, LLC

Alzheimer Center

Lake Mary, Florida

Provider NPI: 1184834228

Organization Information:
Organization Name:  SUMMERVILLE 3, LLC


Practice Location:
150 MIDDLE STREET  LAKE MARY, FL 32746 US
Tel: 407-321-7550  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
FLAL10162
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
FLAL10162

Other Provider Identifiers:

IssuerNumberStateType
0089537-00FL05
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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