Provider Demographics
NPI:1225466055
Name:SOMERSET COMMUNITY ASSISTED LIVING & MEMORY CARE
Entity Type:Organization
Organization Name:SOMERSET COMMUNITY ASSISTED LIVING & MEMORY CARE
Other - Org Name:SOMERSET COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BEN-ACQUAAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:813-600-3778
Mailing Address - Street 1:34731 CHANCEY RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-3704
Mailing Address - Country:US
Mailing Address - Phone:813-600-3778
Mailing Address - Fax:813-395-8421
Practice Address - Street 1:34731 CHANCEY RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-3704
Practice Address - Country:US
Practice Address - Phone:813-600-3778
Practice Address - Fax:813-395-8421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010403300Medicaid