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NPI Code Detail

MEDICARE: SF FOUNTAINHEAD LLC

MEDICARE: SF FOUNTAINHEAD 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
1314000000XSkilled Nursing Facility

Other Identifiers

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

General Provider Information

NPI Number : 1225297062
Entity Type Code : Organization
Provider Name (Legal Business Name) : SF FOUNTAINHEAD LLC
Provider Business Mailing Address
First Line : 44 S BROADWAY
Second Line : SUITE 614
City : WHITE PLAINS
State : NY
Zip : 10601-4425
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 390 NE 135TH ST
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33161-3967
Country : US
Telephone Number : 305-895-4804
Fax Number :
Authorized Official
Title or Position : ASSOCIATE GENERAL COUNSEL
Name : ARI J. MARKENSON
Credential :
Telephone Number : 914-390-4377
Provider Enumeration Date : 06/06/2008
Last Update Date : 12/27/2012

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Directions to “SF FOUNTAINHEAD LLC ” Practice Location

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