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Organization

ACTIVE SENIOR LIVING RESIDENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BETH BESU (ADMINISTRATOR)
(954) 629-4734
Entity
Organization

Contact information

Practice address
9057 NW 57TH ST, TAMARAC, FL 33351-4305
(954) 721-1115
Mailing address
9057 NW 57TH ST, TAMARAC, FL 33351-4305
(954) 721-1115

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9969
FL

Other

Enumeration date
02/05/2014
Last updated
02/05/2014
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