Provider Demographics
NPI:1508188780
Name:SUNDANCE REHAB
Entity Type:Organization
Organization Name:SUNDANCE REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF PT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUFF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:954-961-9522
Mailing Address - Street 1:100 SE 11TH CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-6620
Mailing Address - Country:US
Mailing Address - Phone:954-254-8135
Mailing Address - Fax:
Practice Address - Street 1:2480 N PARK RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3744
Practice Address - Country:US
Practice Address - Phone:954-961-9522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16292310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility