Organization
HERON HOUSE ALF LLC
Active
Other names
Heron House of Largo
Organization subpart
No
Provider details
NPI number
Authorized official
ZEVI KOHN (MEMBER)
(718) 338-2999
Entity
Organization
Contact information
Practice address
2050 E BAY DR, LARGO, FL 33771-2321
(727) 559-7776
Mailing address
2050 E BAY DR, LARGO, FL 33771-2321
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL10811
AHCA
FL
Enumeration date
08/29/2017
Last updated
08/29/2017
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