Organization
60TH AVENUE ALF, LLC
Active
Parent organization
JUPITER TENANT, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JUPITER TENANT, LLC
Authorized official
MR. CHRISTOPHER L WETTIG CPA (CFO)
(316) 616-6288
Entity
Organization
Contact information
Practice address
2800 60TH AVE W, BRADENTON, FL 34207-4324
(941) 752-1990
(941) 752-1740
Mailing address
8415 E 21ST ST N STE 100, WICHITA, KS 67206-2959
(316) 616-6288
(316) 616-6255
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9932
FL
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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