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General NPI Number Information
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NPI Number | 1710644406
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Entity Type | Organization
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Legal Business Name | PARADISE VILLA RETIREMENT HOMES INC
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Dates
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Enumeration Date | 11/17/2021
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 1145 NW 92ND AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-4532
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Country | US
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Telephone | 954-443-0707
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Fax | 954-430-5983
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Provider Business Mailing Address
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Address Line | 4275 NW 67TH WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-3025
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Country | US
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Telephone | 954-444-1306
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Fax | 954-430-5983
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Authorized Official
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Title or Position | C.E.O
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Name | ROBIN P STEWART- BARNETT
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Credential |
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Telephone | 954-444-1306
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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 |
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License Number State |
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