Organization
EXTENDED CARE PORTFOLIO TENANT, LLC
Active
Other names
Pacifica Senior Living Creekside
Organization subpart
No
Provider details
NPI number
Authorized official
MINDY MYERS (MANAGER)
(727) 726-3980
Entity
Organization
Contact information
Practice address
9015 UNIVERSITY PKWY, PENSACOLA, FL 32514-5525
(850) 477-6400
Mailing address
13770 58TH ST N, SUITE 312, CLEARWATER, FL 33760-3759
(727) 726-3980
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
AL9068
FL
Other
Enumeration date
08/13/2013
Last updated
08/13/2013
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