1415 Fort Clarke Blvd Tenant LLC
NPI #1174351183 in Gainesville, Florida
Provider Information
- NPI Number
- 1174351183
- Entity Type
- Organization
- Organization Name
- 1415 Fort Clarke Blvd Tenant LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jul 22, 2024
- Last Updated
- Jul 22, 2024
Practice Location
- Address
- 1415 FORT CLARKE BLVD
- City
- Gainesville
- State
- Florida
- ZIP Code
- 32606-7181
- Phone
- (352) 332-4505
Authorized Official
- Name
- SHARON MAKOWSKY
- Title
- AUTHORIZED REPRESENTATIVE
- Phone
- (419) 247-2800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Alzheimer Center (Dementia Center) |
| Assisted Living Facility |
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