Healthcare Provider Details

I. General information

NPI: 1497009336
Provider Name (Legal Business Name): WHITEHALL OF BOCA RATON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 DEL PRADO CIR S
BOCA RATON FL
33433-3386
US

IV. Provider business mailing address

6 CADILLAC DR SUITE 310
BRENTWOOD TN
37027-5080
US

V. Phone/Fax

Practice location:
  • Phone: 561-392-3000
  • Fax: 561-392-6031
Mailing address:
  • Phone: 615-250-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM ORAND
Title or Position: CEO
Credential:
Phone: 615-250-7100