Provider Demographics
NPI:1871501486
Name:206 MANAGEMENT LLC
Entity Type:Organization
Organization Name:206 MANAGEMENT LLC
Other - Org Name:THE CROSSROADS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:H
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-367-4563
Mailing Address - Street 1:4700 SHERIDAN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3420
Mailing Address - Country:US
Mailing Address - Phone:954-367-4563
Mailing Address - Fax:954-367-4564
Practice Address - Street 1:206 W ORANGE ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-3118
Practice Address - Country:US
Practice Address - Phone:863-422-4961
Practice Address - Fax:863-422-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
105777Medicare Oscar/Certification