OrganizationActive
1415 Fort Clarke Blvd Tenant LLC
NPI 1174351183 · Assisted Living Facility · Gainesville, FL
Provider details
- NPI number
- 1174351183
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Authorized official
- Sharon Makowsky, Authorized Representative
Practice location
1415 Fort Clarke Blvd
Gainesville, FL 32606-7181
Phone: (352) 332-4505
Mailing address
8415 E 21st St N Ste 100
Wichita, KS 67206-2959
Registry dates
- Enumerated
- 2024-07-22
- Last updated
- 2024-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.