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General NPI Number Information
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NPI Number | 1194114496
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Entity Type | Organization
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Legal Business Name | UNLIMITED ESSENTIALS, LLC
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Dates
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Enumeration Date | 01/10/2015
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Last Update Date | 01/10/2015
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Provider Practice Location Address
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Address Line | 470 SW 14TH CT
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City | POMPANO BEACH
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State | FL
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Zip | 33060-8620
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Country | US
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Telephone | 754-307-1432
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Fax |
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Provider Business Mailing Address
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Address Line | 10211 PINES BLVD 213
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-6003
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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 | OWNER
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Name | MRS. SHANIQUE MARTIN-JOHNSON
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Credential |
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Telephone | 954-258-4958
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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 | AL12597
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License Number State | FL
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