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General NPI Number Information
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NPI Number | 1982036125
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Entity Type | Organization
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Legal Business Name | CORRIGAN PLACE, ALF, INC.
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 11420 CORRIGAN ST
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City | SPRING HILL
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State | FL
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Zip | 34609-4706
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Country | US
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Telephone | 727-410-7966
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Fax | 352-200-5222
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Provider Business Mailing Address
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Address Line | 11420 CORRIGAN ST
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City | SPRING HILL
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State | FL
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Zip | 34609-4706
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Country | US
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Telephone | 727-410-7966
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Fax | 352-200-5222
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIFER VARDELEON GUNN
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Credential |
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Telephone | 727-410-7966
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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 | 11814
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License Number State | FL
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