MEDICARE: MANOR OAKS SNF OPERATIONS LLC

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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1376276469
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANOR OAKS SNF OPERATIONS LLC

Provider Business Mailing Address
First Line	:	267 BROADWAY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-6216
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 E COMMERCIAL BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3821
Country	:	US
Telephone Number	:	954-771-8400
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SOLOMON KLEIN
Credential	:
Telephone Number	:	347-909-1811

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	07/06/2022

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