Provider Demographics
NPI:1417153792
Name:ABBEY MANOR RETIREMENT RESIDENCE
Entity Type:Organization
Organization Name:ABBEY MANOR RETIREMENT RESIDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:UEBERLAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-923-1354
Mailing Address - Street 1:1930 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-3510
Mailing Address - Country:US
Mailing Address - Phone:954-923-1354
Mailing Address - Fax:954-926-5837
Practice Address - Street 1:1930 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-3510
Practice Address - Country:US
Practice Address - Phone:954-923-1354
Practice Address - Fax:954-926-5837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10006310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility