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General NPI Number Information
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NPI Number | 1043884596
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Entity Type | Organization
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Legal Business Name | CENTER FOR AGING AND REHABILITATION OF GREENVILLE INC
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 13455 W US 90
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City | GREENVILLE
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State | FL
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Zip | 32331-4318
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Country | US
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Telephone | 954-367-4597
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Fax |
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Provider Business Mailing Address
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Address Line | 3550 POWERLINE RD
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City | OAKLAND PARK
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State | FL
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Zip | 33309-5917
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Country | US
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Telephone | 954-367-4597
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. MARY ANNE WOOD
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Credential |
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Telephone | 954-367-4597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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