Organization
SENIOR HEALTH TLTC, LLC
Active
Other names
Sunrise Village
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD JAFFE (PRESIDENT)
(215) 346-6454
Entity
Organization
Contact information
Practice address
11722 N 17TH ST, TAMPA, FL 33612-5434
(813) 971-8072
(813) 972-9664
Mailing address
11722 N 17TH ST, TAMPA, FL 33612-5434
(813) 971-8072
(813) 972-9664
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5898
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
687721400
—
FL
Enumeration date
04/09/2013
Last updated
04/09/2013
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