Organization
SELAH-GULF BREEZE COURTYARD, LLC
Active
Parent organization
SELAH SENIORCARE II, LLC
Other names
Gulf Breeze Courtyard
Organization subpart
Yes
Provider details
NPI number
Legal business name
SELAH SENIORCARE II, LLC
Authorized official
MR. ALAN DANIEL PARRISH (MANAGER)
(904) 543-1818
Entity
Organization
Contact information
Practice address
3428 GULF BREEZE PKWY, GULF BREEZE, FL 32563-1400
(850) 934-1662
(850) 934-4218
Mailing address
3428 GULF BREEZE PKWY, GULF BREEZE, FL 32563-1400
(850) 934-1662
(850) 934-4218
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9976
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003102500
MEDICAID WAIVER PROGRAM
FL
01
—
109168
AMERICAN ELDERCARE - MEDICAID DIVERSION PROGRAM
FL
01
—
7618
WORLDNET - MEDICAID DIVERSION PROGRAM
FL
Enumeration date
09/10/2013
Last updated
09/10/2013
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