Organization
SRI OF BRANDON MC, LLC
Active
Parent organization
SUPERIOR RESIDENCES, INC
Other names
Superior Residences of Brandon
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPERIOR RESIDENCES, INC
Authorized official
DENNIS MCCARTHY (CIO)
(352) 686-3831
Entity
Organization
Contact information
Practice address
1819 PROVIDENCE RIDGE BLVD, BRANDON, FL 33511-1899
(813) 657-8587
Mailing address
1819 PROVIDENCE RIDGE BLVD, BRANDON, FL 33511-1899
(813) 657-8587
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9739
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9739
AHCA
FL
Enumeration date
12/23/2013
Last updated
12/23/2013
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