Organization
PATTY'S HOUSE 4 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA MAYO (OWNER)
(813) 742-8034
Entity
Organization
Contact information
Practice address
2805 JERRY SMITH RD, DOVER, FL 33527-5449
(813) 752-8034
Mailing address
2805 JERRY SMITH RD, DOVER, FL 33527-5449
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12242
FL
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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