=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144521998
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VEANDA'S COURTS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2010
-----------------------------------------------------
Last Update Date | 11/10/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5511 SW 20TH ST
-----------------------------------------------------
City | WEST PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-3107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-983-8880
-----------------------------------------------------
Fax | 954-966-8544
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5511 SW 20TH ST
-----------------------------------------------------
City | WEST PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33023-3107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-983-8880
-----------------------------------------------------
Fax | 954-966-8544
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | VEANDA THOMAS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-290-1036
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | AL11903
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------