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Organization
SUMMERVILLE 9 LLC
Active
Organization
SUMMERVILLE 9 LLC
Active
Other names
Brookdale Beckett Lake
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER)
(615) 564-8131
Entity
Organization
Contact information
Practice address
2155 MONTCLAIR RD, CLEARWATER, FL 33763-4287
(727) 797-7257
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110301-00
—
FL
Enumeration date
11/17/2009
Last updated
05/13/2016
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