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General NPI Number Information
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NPI Number | 1568582617
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Entity Type | Organization
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Legal Business Name | SHERBY DEVELOPMENT INC.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2144 LINCOLN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-3917
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Country | US
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Telephone | 954-922-1995
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Fax | 954-923-1766
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Provider Business Mailing Address
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Address Line | PO BOX 221650
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City | HOLLYWOOD
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State | FL
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Zip | 33022-1650
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Country | US
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Telephone | 954-922-1995
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Fax | 954-923-1766
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LARRY SHERBERG
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Credential |
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Telephone | 954-922-1995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL5672
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License Number State | FL
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