Organization
EASTSIDE ACTIVE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOSES SYHEAD (MANAGER)
(954) 362-3487
Entity
Organization
Contact information
Practice address
1600 TAFT ST, HOLLYWOOD, FL 33020-3272
(954) 923-5057
(954) 927-7794
Mailing address
1600 TAFT ST, HOLLYWOOD, FL 33020-3272
(954) 923-5057
(954) 927-7794
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL12023
FL
Other
Enumeration date
04/08/2015
Last updated
05/23/2016
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