Organization
HOLLYWOOD BEACH RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RICKI KANETI (ADMINISTRATOR)
(954) 923-1726
Entity
Organization
Contact information
Practice address
1722 MADISON ST, HOLLYWOOD, FL 33020-5537
(954) 923-1726
(954) 923-8535
Mailing address
1722 MADISON ST, HOLLYWOOD, FL 33020-5537
(954) 923-1726
(954) 923-8535
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL5026
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140923900
—
FL
Enumeration date
08/11/2011
Last updated
08/11/2011
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