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NPI Code Detail

MEDICARE: LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE

MEDICARE: LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilitySNF1298095FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225024268
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE
Provider Business Mailing Address
First Line : 315 S FLAGLER DR
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33401-5613
Country : US
Telephone Number : 561-655-8544
Fax Number : 561-650-8952
Provider Business Practice Location Address
First Line : 315 S FLAGLER DR
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33401-5613
Country : US
Telephone Number : 561-655-8544
Fax Number : 561-650-8952
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARY ANNE DENNEHY
Credential : NHA
Telephone Number : 561-655-8544
Provider Enumeration Date : 09/26/2005
Last Update Date : 08/22/2020

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