Genesis Alf of Tampa Management Group Corp

NPI #1417438854 in Valrico, Florida

Provider Information

NPI Number: 1417438854
Entity Type: Organization
Organization Name: Genesis Alf of Tampa Management Group Corp
Primary Specialty: Assisted Living Facility
Enumeration Date: Aug 23, 2018
Last Updated: Aug 23, 2018

Practice Location

Address: 1108 BLACK KNIGHT DR
City: Valrico
State: Florida
ZIP Code: 33594-5800
Phone: (813) 530-0909

Authorized Official

Name: GLADYS KANODEREKA
Title: ADMINISTRATOR
Phone: (813) 330-8424

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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