Provider Demographics
NPI:1700210747
Name:KEVAL EXQUISITE CARE LLC
Entity Type:Organization
Organization Name:KEVAL EXQUISITE CARE LLC
Other - Org Name:KEVAL EXQUISITE CARE 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALLI
Authorized Official - Middle Name:O
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-246-9703
Mailing Address - Street 1:323 NW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9399
Mailing Address - Country:US
Mailing Address - Phone:954-725-9571
Mailing Address - Fax:954-725-9571
Practice Address - Street 1:323 NW 45TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9399
Practice Address - Country:US
Practice Address - Phone:954-725-9571
Practice Address - Fax:954-725-9571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11067310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility