Organization
PINES RETIREMENT RESIDENCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA GIORDANO (ADMINISTRATOR/OWNER)
(754) 244-1296
Entity
Organization
Contact information
Practice address
7740 NW 1ST ST, PEMBROKE PINES, FL 33024-6966
(754) 244-1296
(954) 430-9438
Mailing address
2327 NW 190TH AVE, PEMBROKE PINES, FL 33029-5317
(754) 244-1296
(954) 430-9438
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11447
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002801700
TREATING PROVIDER FOR MANAGED CARE PLAN FOR AMERIGROUP FLORIDA INC
FL
Enumeration date
03/07/2011
Last updated
03/07/2011
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