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General NPI Number Information
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NPI Number | 1740812262
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Entity Type | Organization
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Legal Business Name | LEEWARD ISLE HOMES LLC
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 740 NW 85TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-441-9395
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Fax | 954-252-4028
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Provider Business Mailing Address
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Address Line | 740 NW 85TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-441-9395
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Fax | 954-252-4028
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Authorized Official
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Title or Position | OWNER
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Name | EMILO HERRERA ARIOSA
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Credential |
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Telephone | 941-718-9134
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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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