Organization
SH BECKETT LAKE, LLC.
Active
Other names
THE COLONNADE AT BECKETT LAKE
Organization subpart
No
Provider details
NPI number
Authorized official
SETH WALKER (CFO)
(850) 583-7990
Entity
Organization
Contact information
Practice address
2155 MONTCLAIR RD, CLEARWATER, FL 33763-4287
(727) 797-7257
Mailing address
2573 BARRINGTON CIR, TALLAHASSEE, FL 32308-6805
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10143
ALF LICENSE
FL
05
—
104709600
—
FL
Enumeration date
12/05/2019
Last updated
02/26/2020
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