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General NPI Number Information
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NPI Number | 1871061655
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Entity Type | Organization
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Legal Business Name | SEACOAST AT SUMMERS POINTE LLC
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Dates
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Enumeration Date | 11/09/2018
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 1 SUNSET DR
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City | WINCHESTER
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State | IN
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Zip | 47394-9251
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Country | US
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Telephone | 813-341-2712
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Fax | 765-584-7496
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Provider Business Mailing Address
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Address Line | 1868 HIGHLAND OAKS BLVD STE A
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 813-341-2712
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Fax | 815-935-1992
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARC GERALD FLORES
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Credential |
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Telephone | 813-341-2712
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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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