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General NPI Number Information
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NPI Number | 1306275144
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Entity Type | Organization
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Legal Business Name | GREEN TREE ASSISTED LIVING LLC
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 11/02/2013
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Provider Practice Location Address
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Address Line | 8207 FOREST CITY RD
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City | ORLANDO
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State | FL
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Zip | 32810-2354
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Country | US
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Telephone | 407-295-4861
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Fax | 407-386-6204
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Provider Business Mailing Address
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Address Line | 8207 FOREST CITY RD
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City | ORLANDO
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State | FL
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Zip | 32810-2354
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Country | US
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Telephone | 407-295-4861
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Fax | 407-386-6204
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Authorized Official
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Title or Position | CFO/CEO
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Name | MR. DANA SCOTT
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Credential |
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Telephone | 813-731-8312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL5578
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License Number State | FL
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