Provider Demographics
NPI:1639719081
Name:RETIREMENT FIVE, LLC
Entity Type:Organization
Organization Name:RETIREMENT FIVE, LLC
Other - Org Name:CHATHAM GLEN HEALTHCARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:ROCKEFELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-581-4648
Mailing Address - Street 1:200 CLEARWATER LARGO RD S
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3228
Mailing Address - Country:US
Mailing Address - Phone:727-581-4648
Mailing Address - Fax:
Practice Address - Street 1:16605 SE 74TH SOUILIERE AVE
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162
Practice Address - Country:US
Practice Address - Phone:352-362-1888
Practice Address - Fax:352-358-5640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility