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Organization
SUMMERVILLE AT GOLDEN POND, LLC
Active
Organization
SUMMERVILLE AT GOLDEN POND, LLC
Active
Other names
Brookdale Palma Sola
Organization subpart
No
Provider details
NPI number
Authorized official
BYRAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER)
(615) 564-8131
Entity
Organization
Contact information
Practice address
450 67TH STREET NORTH, BRADENTON, FL 34209
(941) 794-5657
(941) 798-3521
Mailing address
6737 W WASHINGTON ST STE 2300, MILWAUKEE, WI 53214-5650
(414) 918-5000
(206) 301-4500
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL4712
FL
310400000X
Assisted Living Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06905137-00
—
FL
05
—
140353200
—
FL
Enumeration date
05/21/2007
Last updated
06/13/2016
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