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General NPI Number Information
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NPI Number | 1457014417
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Entity Type | Organization
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Legal Business Name | SEGGYYEN VENTURES LLC
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 616 VALLE VISTA DR
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City | BRANDON
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State | FL
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Zip | 33511-7830
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Country | US
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Telephone | 813-662-4107
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Fax |
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Provider Business Mailing Address
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Address Line | 1810 OAK POND ST
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City | RUSKIN
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State | FL
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Zip | 33570-7995
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Country | US
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Telephone | 813-909-5904
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | OLUSEGUN AYENI
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Credential |
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Telephone | 813-909-5904
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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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