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General NPI Number Information
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NPI Number | 1073900569
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Entity Type | Organization
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Legal Business Name | COURTYARDS FACILITY INC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 1900 MERCY DR
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City | ORLANDO
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State | FL
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Zip | 32808-5612
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Country | US
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Telephone | 407-578-4668
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 HOLLYWOOD BLVD #369
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6635
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MR. MICHAEL BLEICH
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Credential |
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Telephone | 845-641-8314
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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 | SNF13920961
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License Number State | FL
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