Provider Demographics
NPI:1760816730
Name:GRAND COURT ALF LLC
Entity Type:Organization
Organization Name:GRAND COURT ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-705-9304
Mailing Address - Street 1:295 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-6933
Mailing Address - Country:US
Mailing Address - Phone:954-942-3388
Mailing Address - Fax:954-942-8901
Practice Address - Street 1:295 SW 4TH AVE
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6933
Practice Address - Country:US
Practice Address - Phone:954-942-3388
Practice Address - Fax:954-942-8901
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
FLAL5464310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL5464OtherPROVIDER LICENSE NUMBER