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SUMMERVILLE AT CARROLLWOOD LLC NPI 1922218361


NPI Information

NPI: 1922218361
Provider Name: SUMMERVILLE AT CARROLLWOOD, LLC

Doing Business As: BROOKDALE CAROLLWOOD

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
13550 SOUTH VILLAGE DRIVE
TAMPA, FL
ZIP 33618
Phone: (813) 908-5300
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SUMMERVILLE AT CARROLLWOOD, 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. SUMMERVILLE AT CARROLLWOOD, LLC NPI is 1922218361. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale Carollwood.

The provider's business location address is:

13550 SOUTH VILLAGE DRIVE
TAMPA, FL
ZIP 33618
Phone: (813) 908-5300
Fax: (813) 908-5304

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

The enumeration date for this NPI number is 5/23/2007 and was last updated on 6/13/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311500000XAlzheimer Center (Dementia Center)No
2310400000XAssisted Living FacilityNo
3310400000XAssisted Living FacilityAL9134FLORIDAYes

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
10111609-00MEDICAIDFLORIDA

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: 4/28/2024

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