Healthcare Provider Details

I. General information

NPI: 1427133115
Provider Name (Legal Business Name): SENIOR LIVING PROPERTIES VI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W. MAITLAND BLVD
MAITLAND FL
32751
US

IV. Provider business mailing address

4661 JOHNSON ROAD, SUITE 7
COCONUT CREEK FL
33073
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-3990
  • Fax: 407-645-3878
Mailing address:
  • Phone: 954-691-1030
  • Fax: 954-691-1036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1635096
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number1635096
License Number StateFL

VIII. Authorized Official

Name: MR. URI RUBIN
Title or Position: MANAGING PARTNER
Credential:
Phone: 954-691-1030