MEDICARE: DWELLING OF POMPANO 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
1	310400000X	Assisted Living Facility

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	:	1518890854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DWELLING OF POMPANO LLC

Provider Business Mailing Address
First Line	:	295 SW 4TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6933
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 SW 4TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33060-6933
Country	:	US
Telephone Number	:	954-942-6000
Fax Number	:

Authorized Official
Title or Position	:	DON
Name	:	ANNIE MATHEW
Credential	:	RN
Telephone Number	:	954-940-1444

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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