National Provider Identifier Database

SUMMERVILLE AT GOLDEN POND LLC
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.


Contact Information

SUMMERVILLE AT GOLDEN POND, LLC
450 67TH STREET NORTH
BRADENTON, FL34209
Phone: 941-794-5657
Fax: 941-798-3521
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for SUMMERVILLE AT GOLDEN POND, LLC

NPI Number 1629287420
Legal business name
LBN
SUMMERVILLE AT GOLDEN POND, LLC
Authorized official BYRAN RICHARDSON - (EVP, CHIEF ADMIN. OFFICER)
Entity Organization
Organization subpart No
Enumeration date 05/21/2007
Last updated 06/13/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: AL4712
  • FL Medicaid: 06905137-00
  • FL Medicaid: 140353200

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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