Organization
PRESTIGIOUS LIFE ASSISTED LIVING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LONG (EXECUTIVE DIRECTOR)
(407) 792-8063
Entity
Organization
Contact information
Practice address
601 49TH ST N, ST PETERSBURG, FL 33710-7320
(727) 318-7844
(727) 683-9890
Mailing address
601 49TH ST N, ST PETERSBURG, FL 33710-7320
(727) 318-7844
(727) 683-9890
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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