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General NPI Number Information
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NPI Number | 1215372057
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Entity Type | Organization
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Legal Business Name | WITH OPEN ARMS RESIDENCE, INC.
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 6801 NW 11TH PL
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City | PLANTATION
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State | FL
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Zip | 33313-6014
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Country | US
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Telephone | 954-587-5895
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Fax | 954-327-2164
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Provider Business Mailing Address
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Address Line | 6801 NW 11TH PL
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City | PLANTATION
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State | FL
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Zip | 33313-6014
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Country | US
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Telephone | 954-587-5895
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Fax | 954-327-2164
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Authorized Official
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Title or Position | OWNER
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Name | MISS ELMA DANIELS
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Credential |
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Telephone | 954-587-5895
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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 | AL10037
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License Number State | FL
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