Organization
ASSISTED LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH WILFRED JOSEPH (PRESIDENT/ADMINISTRATOR)
(813) 374-1580
Entity
Organization
Contact information
Practice address
3011 W DE LEON ST, TAMPA, FL 33609-4001
(813) 374-1580
(813) 425-6925
Mailing address
PO BOX 280339, TAMPA, FL 33682-0339
(813) 374-1580
(813) 425-6925
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL 11504
FL
3104A0625X
Assisted Living Facility (Mental Illness)
AL 11504
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000460000
—
FL
Enumeration date
11/04/2010
Last updated
11/04/2010
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