MEDICARE: ALZHEIMER'S CARE RESOURCE CENTER

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1992051593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALZHEIMER'S CARE RESOURCE CENTER

Provider Business Mailing Address
First Line	:	2328 10TH AVE N
Second Line	:	SUITE 601
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6606
Country	:	US
Telephone Number	:	561-588-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	2328 10TH AVE N
Second Line	:	SUITE 601
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6606
Country	:	US
Telephone Number	:	561-588-4545
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MR. TERRY FORGIE
Credential	:
Telephone Number	:	561-588-4545

Provider Enumeration Date	:	08/01/2012
Last Update Date	:	08/01/2012

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