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NPI Code Detail

MEDICARE: CRESTHAVEN EAST LLC

MEDICARE: CRESTHAVEN EAST LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility04769FL

General Provider Information

NPI Number : 1013001817
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRESTHAVEN EAST LLC
Provider Business Mailing Address
First Line : 5100 CRESTHAVEN BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33415-8618
Country : US
Telephone Number : 561-964-2828
Fax Number : 561-357-5838
Provider Business Practice Location Address
First Line : 5100 CRESTHAVEN BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33415-8618
Country : US
Telephone Number : 561-964-2828
Fax Number : 561-357-5838
Authorized Official
Title or Position : PRESIDENT MANAGING MEMBER
Name : MR. MORTON J GELBERD
Credential :
Telephone Number : 561-964-2828
Provider Enumeration Date : 10/03/2006
Last Update Date : 08/22/2020

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Directions to “CRESTHAVEN EAST LLC ” Practice Location

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