Organization
ORIGIN HOSPITALITY LLC
Active
Other names
Silver Creek Assisted Living St. Cloud
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITESH PATEL (MANAGING MEMBER)
(832) 385-2295
Entity
Organization
Contact information
Practice address
2910 OLD CANOE CREEK RD, SAINT CLOUD, FL 34772
(407) 593-1524
(407) 593-1525
Mailing address
17503 LA CANTERA PKWY #104618, SAN ANTONIO, TX 78257
(832) 385-2295
(855) 557-2835
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11478
FL
Other
Enumeration date
03/26/2013
Last updated
09/25/2019
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