# EXTENDED CARE PORTFOLIO TENANT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pacifica Senior Living Creekside
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932532942
- **Authorized official:** MINDY MYERS (MANAGER)
- **Authorized official phone:** (727) 726-3980

## Contact information

- **Practice address:** 9015 UNIVERSITY PKWY, PENSACOLA, FL 32514-5525
- **Practice address phone:** (850) 477-6400
- **Mailing address:** 13770 58TH ST N, SUITE 312, CLEARWATER, FL 33760-3759
- **Mailing address phone:** (727) 726-3980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | AL9068 | FL | Yes |

## Other

- **Enumeration date:** 08/13/2013
- **Last updated:** 08/13/2013