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Organization
WELL TREVI TENANT LLC
Active
Organization
WELL TREVI TENANT LLC
Active
Other names
The Fountains at Boca Ciega Bay
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN PISANELLI (AUTHORIZED REPRESENTATIVE)
(419) 247-2800
Entity
Organization
Contact information
Practice address
1255 PASADENA AVE S # SOUTHS, SOUTH PASADENA, FL 33707-6203
(727) 381-5411
Mailing address
4500 DORR ST, TOLEDO, OH 43615-4040
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83
STATE OF FLORIDA
FL
Enumeration date
01/31/2022
Last updated
01/19/2023
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