Rivertown Assisted Living LLC
Preferred Provider Organization in Blountstown, FL. Organization (NPI-2).
NPI number1649600156
StatusActive
Last updated in NPPESNov 19, 2013
Details
- NPI
- 1649600156
- Entity type
- Organization (NPI-2)
- Legal business name
- Rivertown Assisted Living LLC
- Organization subpart
- No
- Enumeration date
- Nov 19, 2013
- Last updated
- Nov 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305R00000X | Preferred Provider Organization | 12439 | FL | Yes |
Other names
- N/A (Former Legal Business Name)
Practice location
16354 Sw Chipola RdBlountstown, FL 32424-3943
Phone 850-447-1720
Mailing address
16354 Sw Chipola RdBlountstown, FL 32424-3943
Phone 850-447-1720
Authorized official
Marshell Solomon
Administrator
8504471720
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