Provider Demographics
NPI:1235763491
Name:ATRIUM HEALTH ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:ATRIUM HEALTH ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLORZNAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-454-8080
Mailing Address - Street 1:107 W LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2809
Mailing Address - Country:US
Mailing Address - Phone:904-454-8080
Mailing Address - Fax:
Practice Address - Street 1:9960 ATRIUM WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-6487
Practice Address - Country:US
Practice Address - Phone:904-454-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility