Organization
RUSTIC RETREAT FLORIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL SUFRIN (MEMBER)
(562) 517-0055
Entity
Organization
Contact information
Practice address
1120 N FEDERAL HWY, BOYNTON BEACH, FL 33435-3229
(561) 737-5881
Mailing address
3711 LONG BEACH BLVD STE 900, LONG BEACH, CA 90807-3315
(562) 517-0055
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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