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NPI Code Detail

MEDICARE: ATRIUM HEALTH ASSISTED LIVING LLC

MEDICARE: ATRIUM HEALTH ASSISTED LIVING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1235763491
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATRIUM HEALTH ASSISTED LIVING LLC
Provider Business Mailing Address
First Line : 107 W LEMON AVE
Second Line :
City : MONROVIA
State : CA
Zip : 91016-2809
Country : US
Telephone Number : 904-454-8080
Fax Number :
Provider Business Practice Location Address
First Line : 9960 ATRIUM WAY
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-6487
Country : US
Telephone Number : 904-454-8080
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : CRYSTAL SOLORZNAO
Credential :
Telephone Number : 904-454-8080
Provider Enumeration Date : 02/26/2020
Last Update Date : 02/26/2020

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Directions to “ATRIUM HEALTH ASSISTED LIVING LLC ” Practice Location

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