MEDICARE: NW FEDERATED WOMAN'S CLUB SR DAYCARE & ALZHEIMERS

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	261QA0600X	Adult Day Care Clinic/Center

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	:	1588085146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NW FEDERATED WOMAN'S CLUB SR DAYCARE & ALZHEIMERS

Provider Business Mailing Address
First Line	:	2185 NW 19TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-3436
Country	:	US
Telephone Number	:	954-714-3500
Fax Number	:	954-714-3507

Provider Business Practice Location Address
First Line	:	2185 NW 19TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-3436
Country	:	US
Telephone Number	:	954-714-3500
Fax Number	:	954-714-3507

Authorized Official
Title or Position	:	INTERIM EXECUTIVE DIRECTOR
Name	:	MRS. PATRICIA D JONES
Credential	:
Telephone Number	:	954-714-3500

Provider Enumeration Date	:	12/30/2013
Last Update Date	:	03/22/2023

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