Patty'S House 4 LLC

Organization Active NPI Assisted Living Facility · Dover, FL

NPI 1922401488 · NPPES record last updated Sep 29, 2014

Key facts

NPI
1922401488
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
License
AL12242 (FL)
Legal business name
PATTY'S HOUSE 4 LLC
Practice address
2805 Jerry Smith Rd
Dover, FL 33527-5449
Phone
(813) 752-8034
NPI assigned
Sep 29, 2014
Organization subpart
No

Authorized official

Name
Tonya Mayo
Title
Owner
Phone
(813) 742-8034

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL12242 FL Yes

Addresses

Primary practice location

2805 Jerry Smith Rd
Dover, FL 33527-5449

Mailing address

2805 Jerry Smith Rd
Dover, FL 33527-5449

Other providers in Dover, FL

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

Sources for this page

Verify at the official NPI Registry.