Provider Demographics
NPI:1740857903
Name:PALM BEACH ALF LLC
Entity type:Organization
Organization Name:PALM BEACH ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:JARAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-909-8240
Mailing Address - Street 1:160 SE CELESTIA CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2120
Mailing Address - Country:US
Mailing Address - Phone:561-909-8240
Mailing Address - Fax:
Practice Address - Street 1:160 SE CELESTIA CT
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-2120
Practice Address - Country:US
Practice Address - Phone:561-909-8240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALM BEACH ALF LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility