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General NPI Number Information
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NPI Number | 1700179405
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Entity Type | Organization
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Legal Business Name | PREMIER SENIOR LIVING OF FLORIDA, LLC
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 200 NASSAU ST N
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City | VENICE
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State | FL
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Zip | 34285-1772
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Country | US
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Telephone | 941-485-2404
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Fax | 941-488-3602
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Provider Business Mailing Address
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Address Line | 200 NASSAU ST N
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City | VENICE
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State | FL
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Zip | 34285-1772
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Country | US
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Telephone | 941-485-2404
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Fax | 941-488-3602
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Authorized Official
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Title or Position | BUSINESS OFFICE DIRECTOR
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Name | MISS TAMSIN A DAYMENT
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Credential | FLCORE, BA
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Telephone | 941-485-2404
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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 | 5534
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License Number State | FL
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