Provider Demographics
NPI:1891130787
Name:WALT NOBLE INC.
Entity Type:Organization
Organization Name:WALT NOBLE INC.
Other - Org Name:ROYAL PALM SENIOR RESIDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUSEBIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOBLEFRANCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-491-4041
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:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 5944310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility