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General NPI Number Information
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NPI Number | 1982902680
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Entity Type | Organization
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Legal Business Name | HAMPTON ALF AT GARDENS, LLC
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 12080 SW CR 484
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City | DUNNELLON
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State | FL
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Zip | 34432
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Country | US
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Telephone | 352-489-9698
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Fax | 352-489-7284
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Provider Business Mailing Address
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Address Line | 12080 SW CR 484
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City | DUNNELLON
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State | FL
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Zip | 34432
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Country | US
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Telephone | 352-489-9698
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Fax | 352-489-7284
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | PAM CUTSURIES
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Credential |
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Telephone | 352-804-5040
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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 | AL8142
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License Number State | FL
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