Provider Demographics
NPI:1144657040
Name:SENIOR LIVING II, LLC
Entity type:Organization
Organization Name:SENIOR LIVING II, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RISK MANAGEMENT AND COMPLIANCE MANA
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-330-2660
Mailing Address - Street 1:4301 ANCHOR PLAZA PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-7529
Mailing Address - Country:US
Mailing Address - Phone:941-254-7990
Mailing Address - Fax:844-808-0071
Practice Address - Street 1:1200 54TH AVENUE DR W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-3325
Practice Address - Country:US
Practice Address - Phone:941-254-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12337311500000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)