Provider Demographics
NPI:1346715257
Name:MST HOUSING, LLC
Entity type:Organization
Organization Name:MST HOUSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TABEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-542-0999
Mailing Address - Street 1:599 S COLLIER BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-5509
Mailing Address - Country:US
Mailing Address - Phone:212-542-0999
Mailing Address - Fax:
Practice Address - Street 1:2525 PIERCE ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4393
Practice Address - Country:US
Practice Address - Phone:212-542-0999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-06
Last Update Date:2018-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility