Organization
SOUTHERN LIVE IN
Active
Other names
southern live in of brandon
Organization subpart
No
Provider details
NPI number
Authorized official
MELONIE BESSETTE AMINISTRATOR (PRESIDENT)
(813) 655-0822
Entity
Organization
Contact information
Practice address
619 PRINCETON ST, BRANDON, FL 33511-7129
(813) 655-0822
(813) 681-1482
Mailing address
PO BOX 3528, APOLLO BEACH, FL 33572-1005
(813) 655-0822
(813) 681-1482
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9890
FL
Other
Enumeration date
04/13/2011
Last updated
03/22/2023
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