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SH NORTHDALE LLC NPI 1558908855


NPI Information

NPI: 1558908855
Provider Name: SH NORTHDALE, LLC

Doing Business As: THE COLONNADE AT NORTHDALE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
3401 W BEARSS AVE
TAMPA, FL
ZIP 33618
Phone: (813) 961-1044
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SH NORTHDALE, LLC is an assisted living facility in Tampa, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SH NORTHDALE, LLC NPI is 1558908855. The provider is registered as an organization entity type.
The provider Is Doing Business As The Colonnade At Northdale.

The provider's business location address is:

3401 W BEARSS AVE
TAMPA, FL
ZIP 33618-143
Phone: (813) 961-1044

The provider's authorized official is Seth Walker .
The authorized official title is Cfo and has the following contact phone number (850) 583-7990.

The enumeration date for this NPI number is 12/5/2019 and was last updated on 2/26/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1104709900MEDICAIDFLORIDA
29500OTHERFLORIDAALF LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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