Organization
MARKET STREET EAST LAKE SL, LLC
Active
Other names
Market Street East Lake
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN WILLIAMS (MANAGER AND CFO)
(772) 539-4560
Entity
Organization
Contact information
Practice address
833 E LAKE RD N, TARPON SPRINGS, FL 34688-6308
(727) 202-9314
Mailing address
445 24TH ST STE 300, VERO BEACH, FL 32960-7502
(772) 539-4560
(772) 257-6934
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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