Provider Demographics
NPI:1255385274
Name:CC-AVENTURA, INC.
Entity type:Organization
Organization Name:CC-AVENTURA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP & GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-803-8555
Mailing Address - Street 1:19333 W COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2485
Mailing Address - Country:US
Mailing Address - Phone:305-692-4700
Mailing Address - Fax:305-692-4706
Practice Address - Street 1:19333 W COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2485
Practice Address - Country:US
Practice Address - Phone:305-692-4700
Practice Address - Fax:305-692-4706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility