Organization
SHADY PALMS RETIREMENT HOMES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT SCOTT BENNETT MBA (ADMINISTRATOR)
(813) 961-3072
Entity
Organization
Contact information
Practice address
14527 N FLORIDA AVE, TAMPA, FL 33613-2134
(813) 961-3072
(813) 968-4713
Mailing address
14527 N FLORIDA AVE, TAMPA, FL 33613-2134
(813) 961-3072
(813) 968-4713
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
6694
FL
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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