Organization
IMPERIAL CLUB LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID VONDENBERGER (MANAGER)
(754) 225-5438
Entity
Organization
Contact information
Practice address
2751 NE 183RD ST, AVENTURA, FL 33160-2160
(305) 935-1801
Mailing address
795 RIDGE LAKE BLVD STE 300, MEMPHIS, TN 38120-9475
(754) 225-5438
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/20/2020
Last updated
09/20/2020
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