Organization
I & G ASSISTED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMOGENE JOHNSON (OWNER)
(754) 234-4357
Entity
Organization
Contact information
Practice address
6560 HARBOUR RD, NORTH LAUDERDALE, FL 33068-3838
(754) 234-4357
Mailing address
6560 HARBOUR RD, NORTH LAUDERDALE, FL 33068-3838
(754) 234-4357
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL11032
ACHA
FL
Enumeration date
12/21/2010
Last updated
12/21/2010
Update your record
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