Healthcare Provider Details

I. General information

NPI: 1003817636
Provider Name (Legal Business Name): THE PLACE AT WEST PALM BEACH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2090 N CONGRESS AVE
WEST PALM BEACH FL
33401-8210
US

IV. Provider business mailing address

2090 N CONGRESS AVE
WEST PALM BEACH FL
33401-8210
US

V. Phone/Fax

Practice location:
  • Phone: 561-686-5100
  • Fax: 561-686-9530
Mailing address:
  • Phone: 561-686-5100
  • Fax: 561-686-9530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF16290951
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL8367
License Number StateFL

VIII. Authorized Official

Name: MRS. KIMNIE C BENNETT
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 561-686-5100