Organization
SOUTHERN COMFORT INN BED AND BREAKFAST
Active
Other names
Southern Comfort Inn Adult Day Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE GREEN (OWNER)
(813) 645-6361
Entity
Organization
Contact information
Practice address
2409 W RAVINE DR, RUSKIN, FL 33570-5635
(813) 645-6361
Mailing address
2409 W RAVINE DR, RUSKIN, FL 33570-5635
(813) 645-6361
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
BNB3911919
FL
311ZA0620X
Adult Care Home Facility
BNB3911919
FL
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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