Healthcare Provider Details

I. General information

NPI: 1427710292
Provider Name (Legal Business Name): CENTER FOR AGING AND REHABILITATION OF DANIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2021
Last Update Date: 10/09/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 PHIPPEN WAITERS RD
DANIA BEACH FL
33004-4931
US

IV. Provider business mailing address

3550 POWERLINE RD
FORT LAUDERDALE FL
33309-5917
US

V. Phone/Fax

Practice location:
  • Phone: 954-927-0508
  • Fax: 954-367-4564
Mailing address:
  • Phone: 954-367-4597
  • Fax: 954-367-4564

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: MARY ANNE WOOD
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 954-367-4597