Healthcare Provider Details

I. General information

NPI: 1851896021
Provider Name (Legal Business Name): BKD PALM BEACH GARDENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11381 PROSPERITY FARMS RD
PALM BEACH GARDENS FL
33410-3403
US

IV. Provider business mailing address

6737 W WASHINGTON ST STE 2300
MILWAUKEE WI
53214-5650
US

V. Phone/Fax

Practice location:
  • Phone: 561-694-9709
  • Fax:
Mailing address:
  • Phone: 414-918-5000
  • Fax:

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: JOANNE LESKOWICZ
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 414-918-5000