Provider Demographics
NPI:1659061653
Name:EMERALD GARDENS HOME ALF LLC
Entity Type:Organization
Organization Name:EMERALD GARDENS HOME ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-232-8628
Mailing Address - Street 1:1012 N 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-3810
Mailing Address - Country:US
Mailing Address - Phone:917-232-8638
Mailing Address - Fax:
Practice Address - Street 1:1012 N 72ND AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-3810
Practice Address - Country:US
Practice Address - Phone:917-232-8638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility