Organization
LA GRANDE BELLE ESTATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAVARIS SPRADLEY (MGR)
(786) 200-8897
Entity
Organization
Contact information
Practice address
5898 ORCHARD POND RD, TALLAHASSEE, FL 32303-8200
(786) 200-8897
Mailing address
10031 PINES BLVD STE 226, PEMBROKE PINES, FL 33024-6180
(786) 200-8897
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11123
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000509700
—
FL
Enumeration date
01/13/2011
Last updated
01/13/2011
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