Mg Venice Subtenant LLC

NPI #1285262147 in Venice, Florida

Provider Information

NPI Number: 1285262147
Entity Type: Organization
Organization Name: Mg Venice Subtenant LLC
Primary Specialty: Assisted Living Facility
Enumeration Date: Mar 27, 2020
Last Updated: May 25, 2021

Practice Location

Address: 1121 JACARANDA BLVD
City: Venice
State: Florida
ZIP Code: 34292-4586
Phone: (941) 497-1117

Authorized Official

Name: DOUGLAS D. SPEAR
Title: AUTHORIZED REPRESENTATIVE
Phone: (206) 676-5300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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