Provider Demographics
NPI:1194122697
Name:MEASE LIFE INC
Entity type:Organization
Organization Name:MEASE LIFE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:727-738-3209
Mailing Address - Street 1:700 MEASE PLZ
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6680
Mailing Address - Country:US
Mailing Address - Phone:727-738-3302
Mailing Address - Fax:727-738-3021
Practice Address - Street 1:700 MEASE PLZ
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6680
Practice Address - Country:US
Practice Address - Phone:727-738-3302
Practice Address - Fax:727-738-3021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL7796310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility