Organization
ISLAND SPLENDOR ALF INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELSA JOHNSON (ADMINISTRATOR)
(727) 585-9788
Entity
Organization
Contact information
Practice address
9057 109TH AVE, SEMINOLE, FL 33777-1115
(727) 585-9788
(727) 204-6549
Mailing address
1155 18TH AVE SW, LARGO, FL 33778-1116
(727) 585-9788
(727) 204-6549
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11915
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003477600
—
FL
Enumeration date
12/17/2013
Last updated
12/17/2013
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