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General NPI Number Information
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NPI Number | 1306169156
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Entity Type | Organization
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Legal Business Name | LP HOLLYWOOD, LLC
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 600 N 17TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4606
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Country | US
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Telephone | 954-927-2531
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Fax | 954-927-0425
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Provider Business Mailing Address
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Address Line | 600 N 17TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4606
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Country | US
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Telephone | 954-927-2531
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Fax | 954-927-0425
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Authorized Official
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Title or Position | CFO
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Name | MR. JOHN HARRISON
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Credential |
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Telephone | 502-568-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | SNF11760963
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF11760963
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License Number State | FL
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