SUMMERVILLE 9 LLC NPI 1609103308

NPI Information

  • NPI: 1609103308
  • Provider Name: SUMMERVILLE 9 LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: BROOKDALE BECKETT LAKE
  • CLIA Number: 10D1080675
  • Address: 2155 MONTCLAIR RD
    CLEARWATER, FL
    ZIP 33763
  • Phone: (727) 797-7257

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NPI Details

SUMMERVILLE 9 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. SUMMERVILLE 9 LLC NPI is 1609103308. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale Beckett Lake.

The provider's business location address is:

2155 MONTCLAIR RD
CLEARWATER, FL
ZIP 33763-287
Phone: (727) 797-7257

The provider's authorized official is Bryan Richardson .
The authorized official title is Evp, Chief Admin. Officer and has the following contact phone number (615) 564-8131.

The CLIA number assigned to this NPI record is 10D1080675 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2009 and was last updated on 5/13/2016.

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
1310400000XAssisted Living FacilityAL10143FLORIDAYes

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
10110301-00MEDICAIDFLORIDA

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: 11/21/2025

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