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General NPI Number Information
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NPI Number | 1487955654
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Entity Type | Organization
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Legal Business Name | CHATSWORTH AT WELLINGTON GREEN LLC
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 10330 DEVONSHIRE BLVD
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City | WELLINGTON
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State | FL
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Zip | 33414-9302
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Country | US
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Telephone | 561-795-3360
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31809
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33420-1809
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Country | US
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Telephone | 561-366-6600
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Fax | 561-273-6184
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Authorized Official
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Title or Position | MANAGER
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Name | MR. PAUL M WALCZAK II
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Credential |
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Telephone | 561-366-6600
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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 |
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License Number State | FL
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