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General NPI Number Information
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NPI Number | 1629310420
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Entity Type | Organization
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Legal Business Name | AVANTE CARE OF HOLLYWOOD, INC.
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 1200 ARTHUR ST
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City | HOLLYWOOD
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State | FL
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Zip | 33019-3118
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Country | US
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Telephone | 954-926-5600
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Fax | 954-926-8080
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Provider Business Mailing Address
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Address Line | 5900 LAKE ELLENOR DR STE 700
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City | ORLANDO
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State | FL
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Zip | 32809-4643
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Country | US
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Telephone | 407-216-0101
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Fax | 407-318-2477
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY L. BIEGASIEWICZ
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Credential |
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Telephone | 407-216-0101
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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 | AL9201
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License Number State | FL
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