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General NPI Number Information
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NPI Number | 1902442916
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Entity Type | Organization
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Legal Business Name | ATLANTIS SENIOR CARE, LLC
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 460 NW 40TH CT
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City | OAKLAND PARK
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State | FL
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Zip | 33309-5138
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Country | US
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Telephone | 954-990-8857
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Fax | 954-440-4761
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Provider Business Mailing Address
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Address Line | 10515 VERSAILLES BLVD
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City | WELLINGTON
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State | FL
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Zip | 33449-8084
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Country | US
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Telephone | 561-789-7924
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SUHAN JUNAID
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Credential |
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Telephone | 561-789-7924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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Taxonomy #2
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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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