Organization
SANTA SUSANA ALF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIBY R JACINTO (OWNER/ADMINISTRATION)
(813) 541-0093
Entity
Organization
Contact information
Practice address
11407 LARKWOOD WAY, TAMPA, FL 33625-5608
(813) 962-5741
(813) 962-5741
Mailing address
11407 LARKWOOD WAY, TAMPA, FL 33625-5608
(813) 962-5741
(813) 962-5741
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12568
FL
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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