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General NPI Number Information
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NPI Number | 1881866531
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Entity Type | Organization
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Legal Business Name | ORCHARD PARK AT DEERFIELD CORPORATION
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 3881 NE 3RD AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1259
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Country | US
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Telephone | 954-563-0276
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Fax | 954-563-0785
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Provider Business Mailing Address
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Address Line | 3881 NE 3RD AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1259
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Country | US
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Telephone | 954-563-0276
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Fax | 954-563-0785
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE STOJANOVIC
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Credential |
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Telephone | 954-563-0276
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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 | AL8336
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License Number State | FL
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