Provider Demographics
NPI:1710644406
Name:PARADISE VILLA RETIREMENT HOMES INC
Entity Type:Organization
Organization Name:PARADISE VILLA RETIREMENT HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:STEWART- BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-444-1306
Mailing Address - Street 1:4275 NW 67TH WAY
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3025
Mailing Address - Country:US
Mailing Address - Phone:954-444-1306
Mailing Address - Fax:954-430-5983
Practice Address - Street 1:1145 NW 92ND AVE
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-4532
Practice Address - Country:US
Practice Address - Phone:954-443-0707
Practice Address - Fax:954-430-5983
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARADISE VILLA RETIREMENT HOME INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-17
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility