Provider Type Icon

ROYAL MG3 OF DAVIE OPCO LLC NPI 1770082414


NPI Information

NPI: 1770082414
Provider Name: ROYAL MG3 OF DAVIE, OPCO, LLC

Doing Business As: OAKMONTE VILLAGE OF DAVIE

Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

CLIA Number: 10D2200404

Address:
8201 STIRLING RD
COOPER CITY, FL
ZIP 33328
Phone: (954) 982-2323
Get Directions

ROYAL MG3 OF DAVIE, OPCO, LLC is an assisted living and mental illness assisted living facility in Cooper City, 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. ROYAL MG3 OF DAVIE, OPCO, LLC NPI is 1770082414. The provider is registered as an organization entity type.
The provider Is Doing Business As Oakmonte Village Of Davie.

The provider's business location address is:

8201 STIRLING RD
COOPER CITY, FL
ZIP 33328-009
Phone: (954) 982-2323

The provider's authorized official is Avi Bittan .
The authorized official title is Manager and has the following contact phone number (305) 944-7988.

The CLIA number assigned to this NPI record is 10D2200404 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/8/2018 and was last updated on 2/8/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13104A0625XAssisted Living FacilityAssisted Living, Mental Illness12960FLORIDAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1020500600MEDICAIDFLORIDA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.