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General NPI Number Information
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NPI Number | 1962769836
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Entity Type | Organization
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Legal Business Name | CARING PLACE ALF
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Dates
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Enumeration Date | 04/17/2012
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Last Update Date | 04/17/2012
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Provider Practice Location Address
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Address Line | 2953 NW 10TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-5609
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Country | US
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Telephone | 954-249-3947
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Fax | 954-486-3855
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Provider Business Mailing Address
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Address Line | 2953 NW 10TH CT
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City | FORT LAUDERDALE
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State | FL
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Zip | 33311-5609
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Country | US
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Telephone | 954-249-3947
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Fax | 954-486-3855
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BEVERLY R ROSS
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Credential | RN
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Telephone | 954-249-3947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 10744
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License Number State | FL
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