Provider Demographics
NPI:1679832794
Name:A&L HEALTHCARE CORP
Entity Type:Organization
Organization Name:A&L HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-213-7039
Mailing Address - Street 1:11764 NW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3318
Mailing Address - Country:US
Mailing Address - Phone:954-757-8739
Mailing Address - Fax:954-753-2286
Practice Address - Street 1:11764 NW 30TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3318
Practice Address - Country:US
Practice Address - Phone:954-757-8739
Practice Address - Fax:954-753-2286
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A&L HEALTHCARE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9959310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004510000Medicaid