Organization
CMOJULES LLC
Active
Other names
Pembrook Place
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLLIN B MULDER R.N (ADMINISTRATOR/OWNER)
(727) 536-5865
Entity
Organization
Contact information
Practice address
2331 PEMBROOK DR, CLEARWATER, FL 33764-6548
(727) 536-5865
Mailing address
2331 PEMBROOK DR, CLEARWATER, FL 33764-6548
(727) 536-5865
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003855600
—
FL
Enumeration date
03/04/2013
Last updated
03/04/2013
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