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General NPI Number Information
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NPI Number | 1750756102
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Entity Type | Organization
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Legal Business Name | SEMINOLE SENIOR LIVING
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Dates
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Enumeration Date | 12/10/2015
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 9000 86TH AVE
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City | SEMINOLE
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State | FL
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Zip | 33777-2641
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Country | US
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Telephone | 727-623-9073
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Fax | 727-623-9093
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Provider Business Mailing Address
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Address Line | 5901 US HIGHWAY 19 SUITE7
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2960
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Country | US
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Telephone | 727-623-9073
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Fax | 727-623-9093
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Authorized Official
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Title or Position | DIRECTOR OF ALF OPERSTIOND
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Name | DR. JOHN J ROSS
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Credential | PHD
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Telephone | 727-919-4935
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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 | 12103
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License Number State | FL
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