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General NPI Number Information
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NPI Number | 1518792076
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Entity Type | Organization
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Legal Business Name | CPIF CORAL LANDING OPCO LLC
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 2820 OLD MOULTRIE RD
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-5454
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Country | US
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Telephone | 904-794-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 FAIRVIEW AVE E STE 200
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City | SEATTLE
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State | WA
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Zip | 98102-3698
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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 | AUTHORIZED OFFICIAL
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Name | ALAN SPRAGINS
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Credential |
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Telephone | 206-728-9063
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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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