North Lake Retirement Home
Assisted Living Facility in Hollywood, FL. Organization (NPI-2).
NPI number1417153446
StatusActive
Last updated in NPPESOct 1, 2007
Details
- NPI
- 1417153446
- Entity type
- Organization (NPI-2)
- Legal business name
- North Lake Retirement Home
- Organization subpart
- No
- Enumeration date
- Jun 26, 2007
- Last updated
- Oct 1, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | al7395 | FL | Yes |
Practice location
1222 N 16th AveHollywood, FL 33020-3741
Phone 954-922-2643
Mailing address
1222 N 16th AveHollywood, FL 33020-3741
Phone 954-922-2643
Authorized official
Pascal Bergeron
Asst Adm
9549222643
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