Provider Demographics
NPI:1700395613
Name:SENIOR LIVING PROPERTIES IV, LLC
Entity Type:Organization
Organization Name:SENIOR LIVING PROPERTIES IV, LLC
Other - Org Name:SAVANNAH COURT OF BRANDON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:URI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-691-1030
Mailing Address - Street 1:4611 JOHNSON RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4361
Mailing Address - Country:US
Mailing Address - Phone:954-691-1030
Mailing Address - Fax:
Practice Address - Street 1:824 N PARSONS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-3435
Practice Address - Country:US
Practice Address - Phone:813-643-6767
Practice Address - Fax:813-643-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility