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General NPI Number Information
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NPI Number | 1396010633
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Entity Type | Organization
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Legal Business Name | NANCY'S ADULT FAMILY CARE
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 7660 NW 12TH CT
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City | PLANTATION
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State | FL
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Zip | 33322-4702
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Country | US
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Telephone | 954-476-7185
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Fax | 954-476-1181
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Provider Business Mailing Address
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Address Line | 7660 NW 12TH CT
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City | PLANTATION
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State | FL
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Zip | 33322-4702
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Country | US
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Telephone | 954-476-7185
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Fax | 954-476-1181
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NANNETTE ANTOINETTE SIMPSON
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Credential | ADMINISTRATIVE
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Telephone | 954-476-7185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | AL11012
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License Number State | FL
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