Organization
PHI LLC
Active
Other names
Crystal Oaks of Pinellas
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOYCE S DENHAM LNHA (ADMINISTRATOR)
(727) 548-5566
Entity
Organization
Contact information
Practice address
6767 86TH AVE NORTH, PINELLAS PARK, FL 33782-4597
(727) 548-5566
(727) 548-6644
Mailing address
6767 86TH AVE NORTH, PINELLAS PARK, FL 33782-4597
(727) 548-5566
(727) 548-6644
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF130470981
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026435100
—
FL
01
—
35960917
STATE FACILITY MDS ID NUM
FL
Enumeration date
09/22/2005
Last updated
06/26/2008
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