Provider Demographics
NPI:1649800335
Name:WP CROSSINGS SR-FL HOLDER, LLC
Entity type:Organization
Organization Name:WP CROSSINGS SR-FL HOLDER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO OF MGMT CO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:ROCKEFELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-581-4648
Mailing Address - Street 1:150 E PALMETTO PARK RD STE 700
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4829
Mailing Address - Country:US
Mailing Address - Phone:561-961-7923
Mailing Address - Fax:
Practice Address - Street 1:8451 US 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5450
Practice Address - Country:US
Practice Address - Phone:813-671-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility