Provider Demographics
NPI:1871264788
Name:ROYAL PALM ALF LLC
Entity Type:Organization
Organization Name:ROYAL PALM ALF LLC
Other - Org Name:ROYAL PALM SENIOR RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:EUSEBIO
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBLEFRANCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-592-0087
Mailing Address - Street 1:5121 NE 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3712
Mailing Address - Country:US
Mailing Address - Phone:954-491-4041
Mailing Address - Fax:954-772-4657
Practice Address - Street 1:5121 NE 19TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3712
Practice Address - Country:US
Practice Address - Phone:954-491-4041
Practice Address - Fax:954-772-4657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility