Provider Demographics
NPI:1629310420
Name:AVANTE CARE OF HOLLYWOOD, INC.
Entity Type:Organization
Organization Name:AVANTE CARE OF HOLLYWOOD, INC.
Other - Org Name:MAJESTIC MEMORY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIEGASIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-216-0101
Mailing Address - Street 1:5900 LAKE ELLENOR DR STE 700
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4643
Mailing Address - Country:US
Mailing Address - Phone:407-216-0101
Mailing Address - Fax:407-318-2477
Practice Address - Street 1:1200 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-3118
Practice Address - Country:US
Practice Address - Phone:954-926-5600
Practice Address - Fax:954-926-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL92013104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009938300Medicaid