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General NPI Number Information
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NPI Number | 1386873230
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Entity Type | Organization
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Legal Business Name | OUR CARE HOME ASSISTED LIVING, INC
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 9043 NW 13TH CT
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6636
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Country | US
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Telephone | 954-752-0128
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Fax | 954-752-7208
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Provider Business Mailing Address
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Address Line | 9043 NW 13TH CT
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6636
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Country | US
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Telephone | 954-752-0128
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Fax | 954-752-7208
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS VERONICA O'CONNOR
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Credential | P.A.
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Telephone | 954-592-9239
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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 | AL11057
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License Number State | FL
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