NPI | 1063836781 |
---|---|
Doing Business As | IMMANUEL AT YBOR ASSISTED LIVING FACILITY |
Doing Business As | YETEY ALF,SPRINGSWATER ALF AND IMMANUEL AT YBOR ALF |
Entity Type | Organization |
Authorized Contact | ABIODUN ADEGBOLA Administrator 813-247-5852 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL10756) |
Enumeration Date | 2014-02-17 |
Last Update Date | 2020-04-17 |