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General NPI Number Information
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NPI Number | 1427632546
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Entity Type | Organization
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Legal Business Name | CREF3 FSLP BOCA RATON OWNER LLC
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 9591 YAMATO RD
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City | BOCA RATON
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State | FL
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Zip | 33434-5549
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Country | US
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Telephone | 561-477-8808
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Fax | 561-477-1665
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Provider Business Mailing Address
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Address Line | 1 MARKET PLZ FL 42
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-1126
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. REGIONAL DIRECTOR OF OPERATIONS
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Name | BRYCE WILLIAM ROBINSON
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Credential |
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Telephone | 239-938-6414
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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 |
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License Number State |
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