60TH Avenue Alf, LLC

Organization Active NPI Assisted Living Facility · Bradenton, FL

NPI 1053751693 · NPPES record last updated Jun 27, 2013

Key facts

NPI
1053751693
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
License
AL9932 (FL)
Legal business name
60TH AVENUE ALF, LLC
Practice address
2800 60TH Ave W
Bradenton, FL 34207-4324
Phone
(941) 752-1990
Fax
(941) 752-1740
NPI assigned
Jun 27, 2013
Organization subpart
Yes
Parent organization (as reported)
JUPITER TENANT, LLC

Authorized official

Name
Mr. Christopher L Wettig, CPA
Title
Cfo
Phone
(316) 616-6288

National Provider Directory

Part of
Maize CCRC LLC

Locations

8415 E 21st St N
Ste 100
Wichita, KS 67206

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL9932 FL Yes

Addresses

Primary practice location

2800 60TH Ave W
Bradenton, FL 34207-4324

Mailing address

8415 E 21St St N Ste 100
Wichita, KS 67206-2959
Phone (316) 616-6288

Other providers in Bradenton, FL

All providers in Bradenton, FL · Assisted Living Facility in Florida

Sources for this page

Verify at the official NPI Registry.