Organization
SHALLOW ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YULEISIS MILLAN (ADMINISTRATOR)
(813) 947-1919
Entity
Organization
Contact information
Practice address
9035 SHALLOWFORD LN, PORT RICHEY, FL 34668-4837
(813) 895-4424
Mailing address
9035 SHALLOWFORD LN, PORT RICHEY, FL 34668-4837
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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