Provider Demographics
NPI:1396232112
Name:HCP DELRAY BEACH FL OPCO LLC
Entity Type:Organization
Organization Name:HCP DELRAY BEACH FL OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-498-0134
Mailing Address - Street 1:8020 W ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-9713
Mailing Address - Country:US
Mailing Address - Phone:561-498-0134
Mailing Address - Fax:561-498-3161
Practice Address - Street 1:8020 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-9713
Practice Address - Country:US
Practice Address - Phone:561-498-0134
Practice Address - Fax:561-498-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9881310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019410200Medicaid