Healthcare Provider Details

I. General information

NPI: 1750270005
Provider Name (Legal Business Name): REDEEMED ASSISTED LIVING LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2025
Last Update Date: 07/01/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12103 BRIGHTWATER BLVD
TEMPLE TERRACE FL
33617-1706
US

IV. Provider business mailing address

7901 4TH ST N STE 300
ST. PETERSBURG FL
33792
US

V. Phone/Fax

Practice location:
  • Phone: 813-397-8192
  • Fax:
Mailing address:
  • Phone: 813-397-8192
  • Fax: 813-364-4331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: TAMAR SPAULDING
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 813-397-8192