Organization
GULF COAST JEWISH FAMILY SERVICES
Active
Other names
66TH STREET GROUP HOME
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA J ROBERTSON (CFO)
(727) 479-1800
Entity
Organization
Contact information
Practice address
3180 66TH ST N, ST PETERSBURG, FL 33710-3165
(727) 893-1661
(727) 893-1663
Mailing address
3180 66TH ST N, ST PETERSBURG, FL 33710-3165
(727) 893-1661
(727) 893-1663
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430
ST OF FL AHCA LICENSE
FL
Enumeration date
12/31/2007
Last updated
12/31/2007
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