Organization
AWAKEN ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTAVIA EDWARDS (OWNER)
(813) 998-7136
Entity
Organization
Contact information
Practice address
11102 PURPLE MARTIN BLVD, RIVERVIEW, FL 33579-2429
(813) 998-7136
Mailing address
11102 PURPLE MARTIN BLVD, RIVERVIEW, FL 33579-2429
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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