Organization
FMHR LLC
Active
Other names
Fountain Manor Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL CHAVIN (ADMINISTRATOR)
(305) 895-4804
Entity
Organization
Contact information
Practice address
390 NE 135TH ST, NORTH MIAMI, FL 33161-3967
(305) 895-4804
(305) 892-7411
Mailing address
390 NE 135TH ST, NORTH MIAMI, FL 33161-3967
(305) 895-4804
(305) 892-7411
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF1163096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013244900
—
FL
Enumeration date
07/17/2014
Last updated
11/24/2014
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