Organization
MAGGORIE SHORES HOME LLC
Active
Organization
MAGGORIE SHORES HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD E BRIDGES (OWNER)
(727) 434-1828
Entity
Organization
Contact information
Practice address
5566 MARTIN LUTHER KING ST S, ST PETERSBURG, FL 33705-5139
(727) 434-1828
Mailing address
PO BOX 15421, ST PETERSBURG, FL 33733-5421
(727) 434-1828
(727) 499-7943
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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