OrganizationActive
Autumn House
NPI 1831508241 · Assisted Living Facility (Mental Illness) · St Petersburg, FL
Provider details
- NPI number
- 1831508241
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Daniel Parks, Administrator(727) 564-4956
- License
- AL6677 (FL)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
880 17th Ave S
St Petersburg, FL 33701-5716
Phone: (727) 564-4956
Approximate (ZIP-level) locationGet directions
Mailing address
880 17th Ave S
St Petersburg, FL 33701-5716
Registry dates
- Enumerated
- 2014-08-11
- Last updated
- 2014-08-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.