Organization
PACIFICA BG MABRY LLC
Active
Other names
Tampa Gardens Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK ISRANI (GENERAL MANAGER)
(619) 296-9000
Entity
Organization
Contact information
Practice address
16702 N. DALE MABRY HIGHWAY, TAMPA, FL 33618-1055
(813) 908-2333
(813) 908-3528
Mailing address
1775 HANCOCK STREET, SUITE 200, SAN DIEGO, CA 92110
(619) 296-9000
(619) 296-9090
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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