Organization
CROWN ASSISTED LIVING LLC
Active
Other names
Crown Assisted Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JURIS BERGS (ADMINISTRATOR)
(386) 333-2434
Entity
Organization
Contact information
Practice address
301 MILFORD PL, NEW SMYRNA BEACH, FL 32168-6826
(386) 409-7993
(386) 409-7993
Mailing address
301 MILFORD PL, NEW SMYRNA BEACH, FL 32168-6826
(386) 409-7993
(386) 409-7993
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10584
AL
FL
Enumeration date
06/17/2022
Last updated
06/17/2022
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