Organization
EMERALD GARDEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KAMRAN ROUHANI ALF LICENSE (ADMINISTRATOR)
(727) 669-5014
Entity
Organization
Contact information
Practice address
2159 N MCMULLEN BOOTH RD, CLEARWATER, FL 33759-1418
(727) 669-5014
Mailing address
2159 N MCMULLEN BOOTH RD, CLEARWATER, FL 33759-1418
(727) 669-5014
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL9997
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL9997
FLORIDA, ASSISTED LIVING FACILITY
FL
Enumeration date
09/12/2010
Last updated
09/12/2010
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