Mg Port Charlotte II Subtenant LLC
NPI #1083242945 in Port Charlotte, Florida
Provider Information
- NPI Number
- 1083242945
- Entity Type
- Organization
- Organization Name
- Mg Port Charlotte II Subtenant LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Mar 27, 2020
- Last Updated
- May 25, 2021
Practice Location
- Address
- 18400 COCHRAN BLVD
- City
- Port Charlotte
- State
- Florida
- ZIP Code
- 33948-3343
- Phone
- (941) 766-8900
Authorized Official
- Name
- DOUGLAS D. SPEAR
- Title
- AUTHORIZED REPRESENTATIVE
- Phone
- (206) 676-5300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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