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General NPI Number Information
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NPI Number | 1942477310
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Entity Type | Organization
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Legal Business Name | DELMA HICKS ALF
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 4245 NW 73RD WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-2156
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Country | US
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Telephone | 954-850-1854
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Fax | 954-796-3380
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Provider Business Mailing Address
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Address Line | 4245 NW 73RD WAY
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-2156
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Country | US
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Telephone | 954-850-1854
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Fax | 954-796-3380
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DELMA C HICKS
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Credential | ADMINISTRATOR ALF
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Telephone | 954-850-1854
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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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