Organization
COUNTRYSIDE HAVEN ASSISTED LIVING
Active
Parent organization
COUNTRYSIDE HAVEN ASSISTED LIVING LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTRYSIDE HAVEN ASSISTED LIVING LLC
Authorized official
KATHY COOGAN (OWNER)
(727) 534-6766
Entity
Organization
Contact information
Practice address
6960 COUNTY ROAD 95, PALM HARBOR, FL 34684-4403
(727) 786-8461
(727) 784-0425
Mailing address
6960 COUNTY ROAD 95, PALM HARBOR, FL 34684-4403
(727) 786-8461
(727) 784-0425
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL5305
FL
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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