Provider Demographics
NPI:1346776085
Name:LAURIN MANOR ASSISTED LIVING FACILITY, LLC
Entity Type:Organization
Organization Name:LAURIN MANOR ASSISTED LIVING FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURIN-PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-560-8917
Mailing Address - Street 1:125 S STATE ROAD 7 STE 104-198
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4385
Mailing Address - Country:US
Mailing Address - Phone:954-560-8917
Mailing Address - Fax:561-877-8707
Practice Address - Street 1:5170 SAINT JOHN AVE S
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-1112
Practice Address - Country:US
Practice Address - Phone:561-509-6841
Practice Address - Fax:561-877-8707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility