Organization
ANNIES AT NOREAST LAKE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONIA BOYKINS (OWNER)
(813) 494-7116
Entity
Organization
Contact information
Practice address
12205 NOREAST LAKE DR, TAMPA, FL 33612-4072
(813) 485-0316
Mailing address
13444 CANOPY CREEK DR, TAMPA, FL 33625-5916
(813) 494-7116
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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