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General NPI Number Information
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NPI Number | 1104814979
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Entity Type | Organization
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Legal Business Name | ST. ANNES NURSING CENTER ST. ANNES RESIDENCE INC.
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 11855 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33177-3956
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Country | US
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Telephone | 954-739-6233
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Fax | 954-733-1532
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Provider Business Mailing Address
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Address Line | 11855 QUAIL ROOST DR
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City | MIAMI
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State | FL
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Zip | 33177-3956
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Country | US
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Telephone | 954-739-6233
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Fax | 954-733-1532
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SANDRA CABEZAS
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Credential | NHA
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Telephone | 305-252-4000
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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 | SNF1515096
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | SNF1515096
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1515096
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License Number State | FL
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