Healthcare Provider Details

I. General information

NPI: 1932835295
Provider Name (Legal Business Name): PALM BEACH NURSING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 LAKEWOOD RD
LAKE WORTH FL
33461-3414
US

IV. Provider business mailing address

4405 LAKEWOOD RD
LAKE WORTH FL
33461-3414
US

V. Phone/Fax

Practice location:
  • Phone: 561-969-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: STEVEN LANDA
Title or Position: CEO
Credential:
Phone: 561-969-1400