Majestic on the River LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

6628 Issued in FL

Legal business name

MAJESTIC ON THE RIVER LLC

Practice address

408 SW 7TH Ave
Fort Lauderdale, FL 33312-2567

Phone

(954) 266-4015

Fax

(954) 839-6229

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

Israela Herskovitz

Title

President

Phone

(954) 266-4015

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1396119004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 W CAMINO REAL",
            "address_2": "SUITE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334335511",
            "telephone_number": "954-266-4015",
            "fax_number": "954-839-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SW 7TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122567",
            "telephone_number": "954-266-4015",
            "fax_number": "954-839-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC ON THE RIVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "HERSKOVITZ",
        "authorized_official_first_name": "ISRAELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-266-4015"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "6628",
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "FL",
            "license": "6628",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "6628",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanesha Rashaun Maiten, M.S.W.
• Javier Enrique Maiz
• Fred Majava
• Mehathab Panachimootil Majeed
• Majestic Care Marina Mile LLC
• Hanna Major Wilson, ARNP
• Davis Major
• Onalee Makam
• Andres Makarem, MD
• Edwin James Makarevich

• Assisted Living Facility in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.