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General NPI Number Information
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NPI Number | 1225024268
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Entity Type | Organization
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Legal Business Name | LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 315 S FLAGLER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5613
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Country | US
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Telephone | 561-655-8544
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Fax | 561-650-8952
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Provider Business Mailing Address
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Address Line | 315 S FLAGLER DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-5613
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Country | US
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Telephone | 561-655-8544
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Fax | 561-650-8952
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARY ANNE DENNEHY
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Credential | NHA
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Telephone | 561-655-8544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1298095
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License Number State | FL
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