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Organization

JOHN KNOX VILLAGE OF TAMPA BAY INC

Active
Parent organization
ST. JOSEPH'S HEALTH CARE CENTER
Other names
St. Joseph's John Knox Village
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST. JOSEPH'S HEALTH CARE CENTER
Authorized official
MS. LISA VICARIO LYONS NHA, CPA (EXECUTIVE DIRECTOR)
(813) 632-2391
Entity
Organization

Contact information

Practice address
4100 E. FLETCHER AVE, TAMPA, FL 33613-4863
(813) 632-2455
(813) 632-2388
Mailing address
4100 E. FLETCHER AVE, TAMPA, FL 33613-4863
(813) 632-2455
(813) 632-2388

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL4110
FL
314000000X
Skilled Nursing Facility
SNF1260095
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021028500
FL
01
K68
BLUECROSS BLUESHIELD
FL
Enumeration date
10/03/2005
Last updated
11/07/2014
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