| NPI | 1962403287 |
|---|---|
| Doing Business As | GULF COAST VILLAGE |
| Entity Type | Organization |
| Authorized Contact | KEVIN AHMADI Executive Director 239-772-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: FL snf1188096) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL al7386) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2020-08-22 |