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General NPI Number Information
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NPI Number | 1558774919
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Entity Type | Organization
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Legal Business Name | THE GARDEN OF HEALTH, INC
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 1910 NE 56TH ST
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-2452
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Country | US
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Telephone | 954-958-9757
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Fax | 954-938-5007
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Provider Business Mailing Address
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Address Line | 1910 NE 56TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-2452
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Country | US
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Telephone | 954-958-9757
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL CARDOSO BRANCO
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Credential |
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Telephone | 954-958-9757
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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 | AL10228
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License Number State | FL
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