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General NPI Number Information
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NPI Number | 1902143506
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Entity Type | Organization
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Legal Business Name | BALMORAL COURT ON FRUITVILLE
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Dates
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Enumeration Date | 01/16/2013
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 4004 FRUITVILLE RD
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City | SARASOTA
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State | FL
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Zip | 34232-1617
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Country | US
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Telephone | 941-371-7147
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Fax |
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Provider Business Mailing Address
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Address Line | 4004 FRUITVILLE RD
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City | SARASOTA
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State | FL
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Zip | 34232-1617
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Country | US
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Telephone | 941-371-7147
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | MRS. HONOR PATERSON
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Credential |
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Telephone | 941-504-7626
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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 | AL7221
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License Number State | FL
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