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Organization

MANATEE ASSISTED LIVING FACILITY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAGGIE GIBBS (PRESIDENT)
(941) 704-9861
Entity
Organization

Contact information

Practice address
2524 9TH AVE E, BRADENTON, FL 34208-3010
(941) 704-9861
Mailing address
2524 9TH AVE E, BRADENTON, FL 34208-3010

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AL10165
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141742800
FL
05
691221496
FL
05
691221498
FL
Enumeration date
09/16/2010
Last updated
12/01/2010
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