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General NPI Number Information
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NPI Number | 1700211794
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Entity Type | Organization
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Legal Business Name | AUDREYS TLC INC
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Dates
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Enumeration Date | 09/09/2013
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 10620 NW 29TH CT
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City | SUNRISE
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State | FL
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Zip | 33322
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Country | US
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Telephone | 754-368-9999
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Fax | 954-306-2745
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Provider Business Mailing Address
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Address Line | 10620 NW 29TH CT
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City | SUNRISE
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State | FL
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Zip | 33322-1069
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Country | US
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Telephone | 754-368-9999
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Fax | 954-306-2745
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Authorized Official
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Title or Position | ADMINISTATOR/OWNER
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Name | MS. AUDREY BEVERLY THORPE EVANS
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Credential |
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Telephone | 754-368-9993
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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 | AL12113
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License Number State | FL
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