Provider Demographics
NPI:1558774919
Name:THE GARDEN OF HEALTH, INC
Entity Type:Organization
Organization Name:THE GARDEN OF HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CARDOSO
Authorized Official - Last Name:BRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-958-9757
Mailing Address - Street 1:1910 NE 56TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2452
Mailing Address - Country:US
Mailing Address - Phone:954-958-9757
Mailing Address - Fax:
Practice Address - Street 1:1910 NE 56TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-2452
Practice Address - Country:US
Practice Address - Phone:954-958-9757
Practice Address - Fax:954-938-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10228310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility