Organization
ESC NEW PORT RICHEY, LLC
Active
Other names
Emeritus at Fort Myers
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ALLEN (DIRECTOR OF MEDICAID SERVICES)
(206) 298-2909
Entity
Organization
Contact information
Practice address
1896 PARK MEADOWS DR, FORT MYERS, FL 33907-3738
(239) 939-5421
(239) 939-4751
Mailing address
3131 ELLIOTT AVE, SUITE 500, SEATTLE, WA 98121-1044
(206) 298-2909
(206) 301-4500
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL 5096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
686854100
—
FL
Enumeration date
03/29/2007
Last updated
08/04/2011
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