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General NPI Number Information
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NPI Number | 1174269633
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Entity Type | Organization
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Legal Business Name | HCR MANOR CARE SERVICES OF FLORIDA III, LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 134 S DIXIE HWY STE 207
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-5434
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Country | US
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Telephone | 954-467-7423
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10086
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City | TOLEDO
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State | OH
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Zip | 43699-0086
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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 | DIRECTOR
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Name | MARTIN DAVID ALLEN
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Credential |
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Telephone | 419-252-5734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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