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General NPI Number Information
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NPI Number | 1790136992
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Entity Type | Organization
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Legal Business Name | FOREST SPRING GARDEN LLC
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 7512 SW 5TH STREET
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068
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Country | US
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Telephone | 954-724-2038
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Fax | 954-724-2089
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Provider Business Mailing Address
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Address Line | 7512 SW 5TH STREET
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068
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Country | US
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Telephone | 954-724-2038
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Fax | 954-724-2089
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Authorized Official
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Title or Position | ADMININSTRATOR
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Name | STACY A HUSSAIN
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Credential |
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Telephone | 954-234-4370
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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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