Organization
15TH STREET EAST SNF OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMITAI DAGAN (AUTHORIZED MEMBER)
(727) 443-1588
Entity
Organization
Contact information
Practice address
105 15TH ST E, BRADENTON, FL 34208-1337
(941) 747-8681
Mailing address
105 15TH ST E, BRADENTON, FL 34208-1337
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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