Provider Demographics
NPI:1447597463
Name:AMORE AT KANNER HIGHWAY, LLC
Entity Type:Organization
Organization Name:AMORE AT KANNER HIGHWAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:COSIOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-219-8989
Mailing Address - Street 1:1634 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-7152
Mailing Address - Country:US
Mailing Address - Phone:772-219-8989
Mailing Address - Fax:
Practice Address - Street 1:1634 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-7152
Practice Address - Country:US
Practice Address - Phone:772-219-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9636310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)