Healthcare Provider Details

I. General information

NPI: 1588085146
Provider Name (Legal Business Name): NW FEDERATED WOMAN'S CLUB SR DAYCARE & ALZHEIMERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2013
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 NW 19TH ST
FORT LAUDERDALE FL
33311-3436
US

IV. Provider business mailing address

2185 NW 19TH ST
FORT LAUDERDALE FL
33311-3436
US

V. Phone/Fax

Practice location:
  • Phone: 954-714-3500
  • Fax: 954-714-3507
Mailing address:
  • Phone: 954-714-3500
  • Fax: 954-714-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA D JONES
Title or Position: INTERIM EXECUTIVE DIRECTOR
Credential:
Phone: 954-714-3500