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General NPI Number Information
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NPI Number | 1013963842
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Entity Type | Organization
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Legal Business Name | CARRINGTON PLACE OF ST PETE, LLC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 10501 ROOSEVELT BLVD N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33716-3816
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Country | US
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Telephone | 727-577-3800
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Fax | 727-577-8969
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Provider Business Mailing Address
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Address Line | 10501 ROOSEVELT BLVD N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33716-3816
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Country | US
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Telephone | 727-577-3800
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Fax | 727-577-8969
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Authorized Official
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Title or Position | CFO
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Name | MS. LYNDA S HEBBELN
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Credential |
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Telephone | 727-723-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 10760961
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License Number State | FL
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