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Organization

EXTENDED CARE PORTFOLIO TENANT, LLC

Active
Other names
Pacifica Senior Living Woodmont
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA EDWARDS (MANAGER)
(727) 726-3980
Entity
Organization

Contact information

Practice address
3207 N MONROE ST, TALLAHASSEE, FL 32303-2832
(850) 562-4123
Mailing address
13770 58TH ST N, SUITE 312, CLEARWATER, FL 33760-3759
(727) 726-3980

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL99
FL

Other

Enumeration date
08/20/2013
Last updated
08/20/2013
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