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General NPI Number Information
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NPI Number | 1205262276
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Entity Type | Organization
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Legal Business Name | PARADISE VILLA RETIREMENT HOMES INC
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Dates
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Enumeration Date | 09/22/2013
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Last Update Date | 09/22/2013
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Provider Practice Location Address
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Address Line | 4275 NW 67TH WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-3025
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Country | US
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Telephone | 954-755-5432
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Fax |
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Provider Business Mailing Address
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Address Line | 4275 NW 67TH WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-3025
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Country | US
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Telephone | 954-755-5432
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MRS. ROBIN P STEWART
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Credential | L.P.N
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Telephone | 954-444-1306
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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 | AL11508
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11931
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL 9225
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License Number State | FL
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