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General NPI Number Information
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NPI Number | 1902112659
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Entity Type | Organization
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Legal Business Name | COMMUNITY ASSISTED AND SUPPORTED LIVING, INC.
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 1401 16TH ST
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City | SARASOTA
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State | FL
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Zip | 34236-2519
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Country | US
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Telephone | 941-365-8645
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Fax | 941-955-0520
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Provider Business Mailing Address
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Address Line | 1401 16TH ST
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City | SARASOTA
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State | FL
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Zip | 34236-2519
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Country | US
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Telephone | 941-365-8645
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Fax | 941-955-0520
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Authorized Official
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Title or Position | CEO
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Name | JULIAN S ELLER
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Credential |
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Telephone | 941-225-2373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | 5258
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License Number State | FL
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