Provider Demographics
NPI:1073089629
Name:HOLY CROSS SENIOR SERVICES INC
Entity Type:Organization
Organization Name:HOLY CROSS SENIOR SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRANDENBURG
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:954-776-3012
Mailing Address - Street 1:4875 N FEDERAL HWY FL 10
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4610
Mailing Address - Country:US
Mailing Address - Phone:954-229-8501
Mailing Address - Fax:954-351-4730
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-771-8000
Practice Address - Fax:954-492-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty