Organization
ISLAND SPLENDOR ALF, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELSA M JOHNSON (ADMINISTRATOR)
(727) 585-9788
Entity
Organization
Contact information
Practice address
1155 18TH AVE SW, LARGO, FL 33778-1116
(727) 585-9788
(727) 585-3748
Mailing address
1155 18TH AVE SW, LARGO, FL 33778-1116
(727) 585-9788
(727) 585-3748
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9487
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140313300
—
FL
05
—
678677496
—
FL
Enumeration date
01/04/2007
Last updated
05/27/2008
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