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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:

PrimaryCodeCategory/DescriptionStateLicense Number
N311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
N310400000XNursing & Custodial Care Facilities
Assisted Living Facility
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
FLAL9134

Other Provider Identifiers:

IssuerNumberStateType
0111609-00FL05
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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