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KELLY'S ASSISTED LIVING FACILITY NPI 1881954659


NPI Information

NPI: 1881954659
Provider Name: KELLY'S ASSISTED LIVING FACILITY
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

CLIA Number: 10D2199838

Address:
1451 NW 20TH ST
FORT LAUDERDALE, FL
ZIP 33311
Phone: (954) 524-2867
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KELLY'S ASSISTED LIVING FACILITY is an assisted living and mental illness assisted living facility in Fort Lauderdale, 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. KELLY'S ASSISTED LIVING FACILITY NPI is 1881954659. The provider is registered as an organization entity type.

The provider's business location address is:

1451 NW 20TH ST
FORT LAUDERDALE, FL
ZIP 33311-523
Phone: (954) 524-2867
Fax: (954) 764-2259

The provider's authorized official is Hannah Williams .
The authorized official title is Owner and has the following contact phone number (954) 524-2867.

The CLIA number assigned to this NPI record is 10D2199838 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2012 and was last updated on 5/25/2012.


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 IllnessAL5485FLORIDAYes

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: 11/14/2023

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