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General NPI Number Information
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NPI Number | 1205245578
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Entity Type | Organization
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Legal Business Name | MAGALIE EMILCAR ADULT FAMILY CARE HOME LLC
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 103 W OCEAN DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-4338
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Country | US
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Telephone | 561-572-7051
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Fax | 561-735-7874
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Provider Business Mailing Address
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Address Line | 103 W OCEAN DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-4338
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Country | US
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Telephone | 561-572-7051
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Fax | 561-735-7874
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAGALIE OLISTIN EMILCAR
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Credential | RN
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Telephone | 561-572-7051
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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 | 6906675
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License Number State | FL
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