Healthcare Provider Details

I. General information

NPI: 1750837928
Provider Name (Legal Business Name): LIFE IS PRECIOUS ASSISTED LIVING, L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2527 JACKSON ST
HOLLYWOOD FL
33020-4930
US

IV. Provider business mailing address

2527 JACKSON ST
HOLLYWOOD FL
33020-4930
US

V. Phone/Fax

Practice location:
  • Phone: 954-628-5187
  • Fax: 954-628-5187
Mailing address:
  • Phone: 954-628-5187
  • Fax: 954-628-5187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: EVANS JAMERO
Title or Position: ADMINISTRATOR
Credential:
Phone: 954-628-5187