MEDICARE: Y & G ENTERPRISES,INC

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
1	310400000X	Assisted Living Facility	AL4782	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033525928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	Y & G ENTERPRISES,INC

Provider Business Mailing Address
First Line	:	1835 WILSON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2725
Country	:	US
Telephone Number	:	954-921-4059
Fax Number	:	954-921-4011

Provider Business Practice Location Address
First Line	:	1835 WILSON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2725
Country	:	US
Telephone Number	:	954-921-4059
Fax Number	:	954-921-4011

Authorized Official
Title or Position	:	ADMINISTRATOR - V/P
Name	:	MRS. DORIT ITZCHAKI
Credential	:
Telephone Number	:	954-921-4059

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	07/11/2014

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Directions to “Y & G ENTERPRISES,INC ” Practice Location

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