Organization
GRACE MANOR ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN PANTONIAL (OWNER)
(727) 666-5060
Entity
Organization
Contact information
Practice address
5916 45TH AVE N, SAINT PETERSBURG, FL 33709-5105
(727) 666-5060
Mailing address
5916 45TH AVE N, SAINT PETERSBURG, FL 33709-5105
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
13186
FL
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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