Good Shepherd Assisted Living Facility of Brandon LLC

NPI #1013274091 in Brandon, Florida

Provider Information

NPI Number: 1013274091
Entity Type: Organization
Organization Name: Good Shepherd Assisted Living Facility of Brandon LLC
Primary Specialty: Assisted Living Facility
Enumeration Date: Apr 16, 2012
Last Updated: Apr 16, 2012

Practice Location

Address: 1801 LIDO DRIVE
City: Brandon
State: Florida
ZIP Code: 33511
Phone: (813) 684-4989

Authorized Official

Name: MRS. THELMA LLANTO MANAGAD
Title: ADMINISTRATOR
Phone: (813) 494-2326

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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