Organization
AVA CARES LLC
Active
Other names
AVA CARES II LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER THOMAS DEROSA (ADMINISTRATOR)
(813) 300-6177
Entity
Organization
Contact information
Practice address
616 VALLE VISTA DR, BRANDON, FL 33511-7830
(813) 300-6177
Mailing address
616 VALLE VISTA DR, BRANDON, FL 33511-7830
(813) 300-6177
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12620
FL
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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