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HOLLYWOOD BEACH RETIREMENT HOME NPI 1033498746


NPI Information

NPI: 1033498746
Provider Name: HOLLYWOOD BEACH RETIREMENT HOME
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
1722 MADISON ST
HOLLYWOOD, FL
ZIP 33020
Phone: (954) 923-1726
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HOLLYWOOD BEACH RETIREMENT HOME is an assisted living and mental illness assisted living facility in Hollywood, FL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. HOLLYWOOD BEACH RETIREMENT HOME NPI is 1033498746. The provider is registered as an organization entity type.

The provider's business location address is:

1722 MADISON ST
HOLLYWOOD, FL
ZIP 33020-537
Phone: (954) 923-1726
Fax: (954) 923-8535

The provider's authorized official is Ricki Kaneti .
The authorized official title is Administrator and has the following contact phone number (954) 923-1726.

The enumeration date for this NPI number is 8/11/2011 and was last updated on 8/11/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13104A0625XAssisted Living FacilityAssisted Living, Mental IllnessAL5026FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1140923900MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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