Provider Demographics
NPI:1336440320
Name:ALF AT VERO BEACH LLC
Entity Type:Organization
Organization Name:ALF AT VERO BEACH LLC
Other - Org Name:THE PLACE AT VERO BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-392-0600
Mailing Address - Street 1:3855 INDIAN RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4882
Mailing Address - Country:US
Mailing Address - Phone:850-392-0600
Mailing Address - Fax:850-392-0000
Practice Address - Street 1:3855 INDIAN RIVER BLVD
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4882
Practice Address - Country:US
Practice Address - Phone:850-392-0600
Practice Address - Fax:850-392-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8672310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility