Organization · NPI-2

Consortia Health Long Term Care LLC

Family Medicine · West Palm Beach, FL

NPI number1689152779
StatusActive
Last updated in NPPESDec 28, 2020

Details

NPI
1689152779
Entity type
Organization (NPI-2)
Legal business name
Consortia Health Long Term Care LLC
Organization subpart
No
Enumeration date
Aug 1, 2018
Certification date
Dec 28, 2020
Last updated
Dec 28, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
163WA2000X Registered Nurse, Administrator––
163WC2100X Registered Nurse, Continence Care––
208800000X Urology––
251J00000X Nursing Care––
332B00000X Durable Medical Equipment & Medical Supplies––
363LG0600X Nurse Practitioner, Gerontology––
132700000X Dietary Manager––

Practice location

1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214

Phone 888-375-0219 · Fax 888-712-4684

Mailing address

1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214

Phone 888-375-0219 · Fax 888-712-4684

Other practice locations

501 Congress Ave Ste 150
Austin, TX 78701-3575

Phone 888-375-0219 · Fax 888-712-4684

Authorized official

Amanda Whelpley
Ceo
5618763767

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