Provider Demographics
NPI:1013920495
Name:SENIOR LIVING PROPERTIES V, LLC
Entity Type:Organization
Organization Name:SENIOR LIVING PROPERTIES V, LLC
Other - Org Name:SAVANNAH COVE
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 1:4661 JOHNSON ROAD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073
Mailing Address - Country:US
Mailing Address - Phone:954-691-1030
Mailing Address - Fax:
Practice Address - Street 1:2090 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-8210
Practice Address - Country:US
Practice Address - Phone:561-686-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16290951314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031231200Medicaid
FL031231200Medicaid