Organization
PALMS VILLA RETIREMENT HOME, INC.
Active
Other names
Palms Villa, Palms Villa Retirement Home
Organization subpart
No
Provider details
NPI number
Authorized official
JASON KISSOONLAL (PRESIDENT)
(954) 484-1350
Entity
Organization
Contact information
Practice address
2131 NW 28TH ST, OAKLAND PARK, FL 33311-2136
(954) 484-1350
(954) 527-0505
Mailing address
2131 NW 28TH ST, OAKLAND PARK, FL 33311-2136
(954) 484-1350
(954) 527-0505
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL4990
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140622100
—
FL
Enumeration date
10/10/2008
Last updated
08/26/2020
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