Provider Demographics
NPI:1235620410
Name:TAMPA OAKS SENIOR LIVING
Entity Type:Organization
Organization Name:TAMPA OAKS SENIOR LIVING
Other - Org Name:PROMISE POINTE AT TAMPA OAKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-694-2153
Mailing Address - Street 1:12110 MORRIS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1950
Mailing Address - Country:US
Mailing Address - Phone:813-694-2153
Mailing Address - Fax:
Practice Address - Street 1:12110 MORRIS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-1950
Practice Address - Country:US
Practice Address - Phone:813-694-2153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13142310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility