Organization
JEANETTE BOSTON ALF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE BOSTON (ADMINISTRATOR)
(813) 237-5792
Entity
Organization
Contact information
Practice address
6916 N 30TH ST, TAMPA, FL 33610-1102
(813) 237-5792
(813) 515-7887
Mailing address
6916 N 30TH ST, TAMPA, FL 33610-1102
(813) 237-5792
(813) 515-7887
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
8616AL
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8616AL
ASSISTED LIVING FACILITY
FL
Enumeration date
06/22/2015
Last updated
06/22/2015
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