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General NPI Number Information
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NPI Number | 1053619544
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Entity Type | Organization
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Legal Business Name | PINES RETIREMENT RESIDENCE, INC.
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Dates
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Enumeration Date | 03/07/2011
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Last Update Date | 03/07/2011
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Provider Practice Location Address
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Address Line | 7740 NW 1ST ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6966
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Country | US
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Telephone | 754-244-1296
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Fax | 954-430-9438
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Provider Business Mailing Address
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Address Line | 2327 NW 190TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-5317
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Country | US
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Telephone | 754-244-1296
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Fax | 954-430-9438
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MRS. JULIA GIORDANO
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Credential |
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Telephone | 754-244-1296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11447
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License Number State | FL
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