CMOJULES LLC NPI 1184965097

NPI Information

NPI: 1184965097
Provider Name: CMOJULES LLC

Doing Business As: PEMBROOK PLACE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
2331 PEMBROOK DR
CLEARWATER, FL
ZIP 33764
Phone: (727) 536-5865
Get Directions

CMOJULES LLC is an assisted living facility in Clearwater, 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. CMOJULES LLC NPI is 1184965097. The provider is registered as an organization entity type.
The provider Is Doing Business As Pembrook Place.

The provider's business location address is:

2331 PEMBROOK DR
CLEARWATER, FL
ZIP 33764-548
Phone: (727) 536-5865

The provider's authorized official is Collin B Mulder .
The authorized official title is Administrator/owner and has the following contact phone number (727) 536-5865.

The enumeration date for this NPI number is 3/4/2013 and was last updated on 3/4/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility				Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003855600	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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