Provider Demographics
NPI:1437792561
Name:REIGN GARDENS GROUP LLC
Entity Type:Organization
Organization Name:REIGN GARDENS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JED
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-593-3599
Mailing Address - Street 1:9355 SW 158TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-5872
Mailing Address - Country:US
Mailing Address - Phone:786-878-5140
Mailing Address - Fax:305-901-1381
Practice Address - Street 1:9355 SW 158TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-5872
Practice Address - Country:US
Practice Address - Phone:786-878-5140
Practice Address - Fax:305-901-1381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility