Organization
GREEN LIFE ASSISTED LIVING FACILITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARI CLARK (CEO)
(813) 931-1433
Entity
Organization
Contact information
Practice address
840 SW 8TH ST, POMPANO BEACH, FL 33060-8214
(855) 331-6615
(855) 638-4902
Mailing address
840 SW 8TH ST, POMPANO BEACH, FL 33060-8214
(855) 331-6615
(855) 638-4902
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12577
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013937500
—
FL
Enumeration date
10/29/2014
Last updated
03/05/2015
Update your record
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