Organization
BEACHSIDE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VADIM MEZRIN (OWNER)
(908) 240-5854
Entity
Organization
Contact information
Practice address
420 N RIVERSIDE DR, POMPANO BEACH, FL 33062-5035
(954) 788-8350
Mailing address
111 N POMPANO BEACH BLVD APT 1104, POMPANO BEACH, FL 33062-5716
(908) 240-5854
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
10156
FL
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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