Provider Demographics
NPI:1700179405
Name:PREMIER SENIOR LIVING OF FLORIDA, LLC
Entity type:Organization
Organization Name:PREMIER SENIOR LIVING OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAMSIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAYMENT
Authorized Official - Suffix:
Authorized Official - Credentials:FLCORE, BA
Authorized Official - Phone:941-485-2404
Mailing Address - Street 1:200 NASSAU ST N
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-1772
Mailing Address - Country:US
Mailing Address - Phone:941-485-2404
Mailing Address - Fax:941-488-3602
Practice Address - Street 1:200 NASSAU ST N
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-1772
Practice Address - Country:US
Practice Address - Phone:941-485-2404
Practice Address - Fax:941-488-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5534310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility