Healthcare Provider Details

I. General information

NPI: 1518890854
Provider Name (Legal Business Name): DWELLING OF POMPANO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 SW 4TH AVE
POMPANO BEACH FL
33060-6933
US

IV. Provider business mailing address

295 SW 4TH AVE
POMPANO BEACH FL
33060-6933
US

V. Phone/Fax

Practice location:
  • Phone: 954-942-6000
  • Fax:
Mailing address:
  • Phone:
  • 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: ANNIE MATHEW
Title or Position: DON
Credential: RN
Phone: 954-940-1444