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Nic 4 The Plaza Leasing Llc
Assisted Living Facility in Pembroke Park, Florida
NPI 1659715027

Nic 4 The Plaza Leasing Llc is an Assisted Living Facility based in Lake Oswego, FL. Nic 4 The Plaza Leasing Llc practices in Pembroke Park, FL. The NPI Number for Nic 4 The Plaza Leasing Llc is 1659715027 and holds a License No. 5120 (Florida).

The current practice location address for Nic 4 The Plaza Leasing Llc is 3535 Sw 52Nd Ave., Pembroke Park, FL and can be reached out via phone at 954-961-8111 and via fax at 954-964-2871.

Location: 3535 Sw 52Nd Ave., Pembroke Park, FL, 97035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1659715027
Provider Name
Nic 4 The Plaza Leasing Llc
Credential
Provider Entity Type
Organization
Address
3535 Sw 52Nd Ave., Pembroke Park, FL, 97035
Phone Number
954-961-8111
Fax Number
954-964-2871
Provider Enumeration Date
04/29/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0047736 01 FL HOME & COMMUNITY BASED SERVICES
institution
Provider Business Practice Location Address Details
Address
3535 Sw 52Nd Ave.
City
Pembroke Park
State
Florida
Zip
33801
Phone Number
954-961-8111
Fax Number
954-964-2871
person
Provider Business Mailing Address Details
Address
3535 Sw 52Nd Ave.
City
Pembroke Park
State
Florida
Zip
33801
Phone Number
954-961-8111
Fax Number
954-964-2871
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
5120 (Florida)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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