Organization
INNOVATIVE SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL BOTERO PT (TEAM LEADER)
(954) 970-2600
Entity
Organization
Contact information
Practice address
8241 SW 15TH ST, 1122, PLANTATION, FL 33324-3271
(954) 882-8618
Mailing address
3701 W MCNAB RD, POMPANO BEACH, FL 33069-4966
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
OTA 10427
FL
310400000X
Assisted Living Facility
OTA 10427
FL
314000000X
Skilled Nursing Facility
OTA 10427
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA 10427
OTA LICENSE NUMBER
FL
Enumeration date
09/11/2008
Last updated
09/11/2008
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