SUMMERVILLE AT CARROLLWOOD, LLC
Alzheimer Center
Tampa, Florida
Provider NPI: 1922218361
Organization Information:Organization Name: SUMMERVILLE AT CARROLLWOOD, LLC
Practice Location:
13550 SOUTH VILLAGE DRIVE TAMPA, FL 33618 US
Tel: 813-908-5300 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
13550 SOUTH VILLAGE DRIVE TAMPA, FL 33618 US
Tel: 813-908-5300 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | ||
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | ||
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | FL | AL9134 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
0111609-00 | FL | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin