Organization
BEACH CLUB ADULT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAVEL PORTNOY (CEO)
(917) 848-1611
Entity
Organization
Contact information
Practice address
2500 HALLANDALE BLVD, SUITE T, HALLANDALE BEACH, FL 33009
(305) 879-6253
(954) 457-4422
Mailing address
2500 E HALLANDALE BLVD, SUITE T, HALLANDALE BEACH, FL 33009
(305) 879-6253
(954) 457-4422
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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