EXTENDED CARE PORTFOLIO FLORIDA TENANT LLC NPI 1679984389

NPI Information

EXTENDED CARE PORTFOLIO FLORIDA TENANT LLC is an assisted living facility in Fort Myers, 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. EXTENDED CARE PORTFOLIO FLORIDA TENANT LLC NPI is 1679984389. The provider is registered as an organization entity type.
The provider Is Doing Business As Pacifica Senior Living Fort Myers.

The provider's business location address is:

9461 HEALTHPARK CIR
FORT MYERS, FL
ZIP 33908-614
Phone: (239) 437-5511
Fax: (239) 437-2826

The provider's authorized official is Depak Israni .
The authorized official title is General Manager and has the following contact phone number (619) 296-9000.

The CLIA number assigned to this NPI record is 10D0948637 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/15/2014 and was last updated on 5/15/2014.

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:

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