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General NPI Number Information
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NPI Number | 1720245681
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Entity Type | Organization
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Legal Business Name | CSH VERO BEACH LP
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 06/03/2015
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Provider Practice Location Address
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Address Line | 2425 20TH STREET HORIZON BAY VERO BEACH
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City | VERO BEACH
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State | FL
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Zip | 32960
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Country | US
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Telephone | 772-770-2401
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Fax |
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Provider Business Mailing Address
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Address Line | 6737 W WASHINGTON ST SUITE 2300,
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City | MILWAUKEE
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State | WI
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Zip | 53214
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Country | US
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Telephone | 772-770-2401
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER (CFO)
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Name | MARK OHLENDORF
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Credential |
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Telephone | 414-918-5403
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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 | AL10057
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License Number State | FL
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