Organization
SA-PG-CLEARWATER LLC
Active
Other names
Palm Garden of Clearwater
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX PALEY (COO)
(914) 390-4363
Entity
Organization
Contact information
Practice address
3480 N MCMULLEN BOOTH RD, CLEARWATER, FL 33761-1421
(727) 786-6697
(727) 781-0516
Mailing address
3480 MCMULLEN BOOTH ROAD, CLEARWATER, FL 33761
(727) 786-6697
(727) 781-0516
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1407096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025746000
—
FL
Enumeration date
06/22/2005
Last updated
07/22/2008
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