# EAST RIDGE RETIREMENT VILLAGE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194042192
- **Authorized official:** MR. GARY M. GREGORY (CHAIRMAN OF THE BOARD)
- **Authorized official phone:** (305) 669-6000

## Contact information

- **Practice address:** 19301 SW 87TH AVENUE, MIAMI, FL 33157-8999
- **Practice address phone:** (305) 238-2623
- **Practice address fax:** (305) 256-3516
- **Mailing address:** 19301 SW 87TH AVENUE, MIAMI, FL 33157-8999
- **Mailing address phone:** (305) 238-2623
- **Mailing address fax:** (305) 256-3516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 20315096 | FL | Yes |

## Other

- **Enumeration date:** 04/29/2010
- **Last updated:** 04/29/2010