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General NPI Number Information
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NPI Number | 1710265590
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Entity Type | Organization
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Legal Business Name | DEERFIELD ASSISTED LIVING
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 4001 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-9408
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Country | US
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Telephone | 954-426-9700
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Fax | 954-428-4337
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Provider Business Mailing Address
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Address Line | 4001 W HILLSBORO BLVD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-9408
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Country | US
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Telephone | 954-426-9700
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Fax | 954-428-4337
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. RICHARD WALSH
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Credential |
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Telephone | 954-818-6400
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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 | AL4777
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License Number State | FL
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