Organization
POTTER'S HOUSE AT CANNON POINT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA BUCHANAN (ADMINISTRATOR)
(954) 733-3366
Entity
Organization
Contact information
Practice address
5820 5830 NW 27TH CT, LAUDERHILL, FL 33313-2330
(954) 733-3366
(954) 733-2993
Mailing address
5820 5830 NW 27TH CT, LAUDERHILL, FL 33313-2330
(954) 733-3366
(954) 733-2993
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10434
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002314100
—
FL
Enumeration date
10/23/2017
Last updated
10/23/2017
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