Organization
PORTLAND ASSISTED LIVING FACILITY
Active
Parent organization
PORTLAND HEALTHCARE INC
Other names
Portland ALF
Organization subpart
Yes
Provider details
NPI number
Legal business name
PORTLAND HEALTHCARE INC
Authorized official
MR. RANDY S MOODIE PHARM.D (ADMINISTRATOR)
(561) 870-8546
Entity
Organization
Contact information
Practice address
4664 NW 58TH TER, CORAL SPRINGS, FL 33067-2115
(954) 603-6954
Mailing address
8758 COBBLESTONE POINT CIR, BOYNTON BEACH, FL 33472-4458
(561) 870-8546
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12536
FL
Other
Enumeration date
04/03/2015
Last updated
04/03/2015
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