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Organization

BAYVUE ASSISTED LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TENNILLE JOPLIN (ADMINISTRATOR)
(813) 391-8398
Entity
Organization

Contact information

Practice address
2506 LITHIA PINECREST RD, VALRICO, FL 33596-5036
(813) 436-0735
(813) 436-0735
Mailing address
3433 LITHIA PINECREST RD STE 135, VALRICO, FL 33596-6302

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12895
FL
3104A0625X
Assisted Living Facility (Mental Illness)

Other

Enumeration date
10/06/2016
Last updated
10/06/2016
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