Healthcare Provider Details

I. General information

NPI: 1760712681
Provider Name (Legal Business Name): SENIOR LIFESTYLES NEWPORT LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2009
Last Update Date: 12/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4733 NW 7TH CT
BOYNTON BEACH FL
33426-9373
US

IV. Provider business mailing address

4733 NW 7TH CT
BOYNTON BEACH FL
33426-9373
US

V. Phone/Fax

Practice location:
  • Phone: 561-586-2989
  • Fax: 561-586-2999
Mailing address:
  • Phone: 561-586-2989
  • Fax: 561-586-2999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number9811
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number9811
License Number StateFL

VIII. Authorized Official

Name: MATTHEW SARNELLI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 561-586-2989