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General NPI Number Information
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NPI Number | 1407117856
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Entity Type | Organization
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Legal Business Name | EXQUISITE SENIOR CARE
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Dates
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Enumeration Date | 06/01/2012
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 2616 WASHINGTON ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5711
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Country | US
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Telephone | 954-274-6849
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Fax |
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Provider Business Mailing Address
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Address Line | 2616 WASHINGTON ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5711
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Country | US
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Telephone | 954-274-6849
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY SMITH
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Credential |
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Telephone | 954-274-6849
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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 | 11251
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License Number State | FL
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