Healthcare Provider Details

I. General information

NPI: 1154318053
Provider Name (Legal Business Name): RICHMOND HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 N NOB HILL RD
SUNRISE FL
33351-4722
US

IV. Provider business mailing address

4800 N NOB HILL RD
SUNRISE FL
33351-4722
US

V. Phone/Fax

Practice location:
  • Phone: 954-577-3600
  • Fax: 954-746-0261
Mailing address:
  • Phone: 954-577-3600
  • Fax: 954-746-0261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1536096
License Number StateFL

VIII. Authorized Official

Name: MRS. DORIS M PETERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 954-577-3600