Meadow Brook Retirement Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9113 Issued in FL

Legal business name

MEADOW BROOK RETIREMENT HOME INC

Practice address

6741 Evans St
Hollywood, FL 33024-1809

Phone

(954) 983-8077

Fax

(954) 983-2274

NPI assigned

May 19, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Audrianna R Frankson

Title

Pres

Phone

(954) 983-8077

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1285869354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 EVANS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330241809",
            "telephone_number": "954-983-8077",
            "fax_number": "954-983-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 EVANS ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330241809",
            "telephone_number": "954-983-8077",
            "fax_number": "954-983-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOW BROOK RETIREMENT HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "FRANKSON",
        "authorized_official_first_name": "AUDRIANNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "954-983-8077"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "678736300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Hollywood, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.