Provider Demographics
NPI:1275244428
Name:DAVIE CARING OPCO LLC
Entity Type:Organization
Organization Name:DAVIE CARING OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-609-7614
Mailing Address - Street 1:4681 SW 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4340
Mailing Address - Country:US
Mailing Address - Phone:954-581-9111
Mailing Address - Fax:954-827-0871
Practice Address - Street 1:4681 SW 66TH AVE
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4340
Practice Address - Country:US
Practice Address - Phone:954-581-9111
Practice Address - Fax:954-827-0871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility