Healthcare Provider Details
I. General information
NPI: 1164079240
Provider Name (Legal Business Name): SNH FLA TENANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2019
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8500 ROYAL PALM BLVD
CORAL SPRINGS FL
33065-5715
US
IV. Provider business mailing address
255 WASHINGTON ST STE 300
NEWTON MA
02458-1634
US
V. Phone/Fax
- Phone: 954-752-9500
- Fax: 954-752-4413
- Phone: 617-796-8350
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
F.
MINTZER
Title or Position: PRESIDENT & CHIEF OPERATING OFFICER
Credential:
Phone: 617-796-8350