Provider Demographics
NPI:1750618690
Name:ATENDA NURSING CARE
Entity type:Organization
Organization Name:ATENDA NURSING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SHERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURSIQUOT
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:305-305-3857
Mailing Address - Street 1:2510 SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2357
Mailing Address - Country:US
Mailing Address - Phone:305-305-3857
Mailing Address - Fax:954-923-3205
Practice Address - Street 1:2510 SCOTT STREET
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020
Practice Address - Country:US
Practice Address - Phone:305-305-3857
Practice Address - Fax:954-923-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15426398310400000X
FL311Z00000X311Z00000X
302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility