Organization
A BANYAN RESIDENCE AT WILDWOOD, LLC
Active
Parent organization
A BANYAN RESIDENCE ASSISTED LIVING LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
A BANYAN RESIDENCE ASSISTED LIVING LLC
Authorized official
GREG ANDERSON (MANAGING MEMBER)
(954) 536-4066
Entity
Organization
Contact information
Practice address
12427 COUNTY ROAD 101, OXFORD, FL 34484-2941
(954) 854-8895
(941) 412-4749
Mailing address
2515 SHERMAN OAK DR, NORTH PORT, FL 34289-2390
(941) 249-0456
(941) 412-4749
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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