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Organization

2595 HARBOR BLVD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSH ROSEN (MANAGER)
(469) 619-5372
Entity
Organization

Contact information

Practice address
2595 HARBOR BLVD, PORT CHARLOTTE, FL 33952-6732
(941) 769-9100
Mailing address
5307 E MOCKINGBIRD LN STE 575, DALLAS, TX 75206-5109
(469) 619-5372

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
03/08/2022
Last updated
11/15/2022
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