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General NPI Number Information
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NPI Number | 1154805802
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Entity Type | Organization
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Legal Business Name | PALLISER ASSISTED LIVING LLC
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 9536 OLD PINE RD
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City | BOCA RATON
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State | FL
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Zip | 33428-3056
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Country | US
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Telephone | 954-682-1985
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Fax | 754-484-4321
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Provider Business Mailing Address
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Address Line | 9536 OLD PINE RD
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City | BOCA RATON
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State | FL
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Zip | 33428-3056
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Country | US
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Telephone | 954-682-1985
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Fax | 754-484-4321
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GABRIELA JANETA ROMAN
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Credential |
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Telephone | 954-682-1985
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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 |
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License Number State |
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