SUMMERVILLE 9 LLC (NPI# 1609103308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609103308 |
| Entity Type | Organization |
| Organization Name | SUMMERVILLE 9 LLC |
| Other Organization Name | BROOKDALE BECKETT LAKE |
| Practice Address |
2155 Montclair Rd Clearwater FL 33763-4287 |
| Mailing Address |
6737 W Washington St Suite 2300 Milwaukee WI 53214-5647 |
| Practice Telephone | 7277977257 |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2016-05-13 |
| Authorized Official Name | BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER) |
| Authorized Official Telephone | 6155648131 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL10143 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0110301-00 | 05 |
| Other Name | Type Code |
|---|---|
| Brookdale Beckett Lake | Doing Business As Name - Organization |
| Street Address |
2155 MONTCLAIR RD |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33763-4287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837143 | Sh Beckett Lake, LLC. | Assisted Living Facility | 2155 Montclair Rd, Clearwater, FL 33763-4287 | 2019-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205201613 | Joshua Roop | Counselor | 2725 Park Dr Ste 2f, Clearwater, FL 33763 | 2015-12-10 |
| 1093184863 | Anthony Joe Adams | Dentist | 25877 Us Highway 19 N, Clearwater, FL 33763 | 2015-09-22 |
| 1568893840 | Shawna Byrd | Counselor | 2725 Park Dr Ste 2e, Clearwater, FL 33763 | 2013-12-11 |
| 1265670178 | Clearwater Chiropractic Center LLC | Chiropractor | 25400 Us Highway 19 North, Suite 112, Clearwater, FL 33763 | 2009-01-30 |
| 1447472667 | Comfortable Care Dental Health Professionals, Pa | Dentist | 2555 Enterprise Road, Suite 3, Clearwater, FL 33763 | 2007-05-03 |
| 1376679464 | Mary Ellen Baker-gayne | Counselor | 2555 Enterprise Rd., Ste. 2, Clearwater, FL 33763 | 2007-02-26 |
| 1669524708 | Robert Steven Colen | Counselor | 24761 Us 19 North, Ste 680, Clearwater, FL 33763 | 2007-01-17 |
| 1780758037 | Diana Lynn Summers Denta | Social Worker | 24761 Us Hwy 19 N, Suite 680, Clearwater, FL 33763 | 2006-11-20 |
| 1891808952 | Cynthia Douglas Lewis | Chiropractor | 24945 Us 19 N, Clearwater, FL 33763 | 2006-08-15 |
| 1285641084 | David P Crowley | Chiropractor | 24945 Us Hwy 19 N, Clearwater, FL 33763 | 2006-08-02 |
| Find all providers in zip 33763 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156279 | Lots Care Company Inc | Assisted Living Facility | 202 Cove Ct, Clearwater, FL 33756-1728 | 2019-10-21 |
| 1538626064 | Gv Clearwater, LLC | Assisted Living Facility | 2750 Drew St, Clearwater, FL 33759-3034 | 2019-02-20 |
| 1770002651 | American Advanced Senior Care LLC | Assisted Living Facility | 2298 Bellaire Road, Clearwater, FL 33764 | 2017-09-12 |
| 1013313246 | Sunset Villa Retirement Home | Assisted Living Facility | 2308 Americus Dr, Clearwater, FL 33763-4503 | 2014-11-17 |
| 1023411246 | Heritage House Retirement Home | Assisted Living Facility | 1810 S Belcher Rd, Clearwater, FL 33764-6602 | 2014-10-01 |
| 1316352172 | Fi-highland Pines LLC | Assisted Living Facility | 1520 Jeffords St, Clearwater, FL 33756-4449 | 2014-06-30 |
| 1710302526 | Pinnacle Health Facilities Xxxii Lp | Assisted Living Facility | 440 N 4th St, Clearwater, KS 67026-9708 | 2014-03-03 |
| 1295159903 | Hillside Gardens Inc | Assisted Living Facility | 3434 Zara Way, Clearwater, FL 33761-1225 | 2014-02-17 |
| 1245654706 | Smith Health Care Properties - Clearwater | Assisted Living Facility | 2057 Edgewater Dr, Clearwater, FL 33755-1028 | 2014-02-04 |
| 1134550718 | Lovely Care Manor LLC | Assisted Living Facility | 2869 Sarah Dr, Clearwater, FL 33759-2010 | 2013-12-06 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33763 |
Please comment or provide details below to improve the information on SUMMERVILLE 9 LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.