Organization
PLAZA OF PEMBROKE ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZEVI KOHN (MEMBER)
(718) 338-2999
Entity
Organization
Contact information
Practice address
3535 SW 52ND AVE, PEMBROKE PARK, FL 33023-5420
(954) 961-8111
Mailing address
3535 SW 52ND AVE, PEMBROKE PARK, FL 33023-5420
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5120
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5120
ALF
FL
Enumeration date
09/14/2017
Last updated
09/14/2017
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