Organization
LTCSP ST. PETERSBURG, LLC
Active
Other names
Long Term Care of St. Petersburg
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD JAFFE (PRESIDENT)
(215) 346-6454
Entity
Organization
Contact information
Practice address
3479 54TH AVE N, ST PETERSBURG, FL 33714-2426
(727) 527-7315
(727) 526-5887
Mailing address
1675 PALM BEACH LAKES BLVD, SUITE 900, WEST PALM BEACH, FL 33401
(561) 801-7600
(414) 268-4811
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF14800962
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028190500
—
FL
Enumeration date
06/13/2005
Last updated
10/05/2012
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