Avalon Park Retirement Residence

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL6653 Issued in FL

Legal business name

AVALON PARK RETIREMENT RESIDENCE

Practice address

600 N 62ND Ave
Hollywood, FL 33024-7857

Phone

(954) 981-4822

Fax

(954) 963-9561

NPI assigned

Jun 11, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Maggie Kulnick

Title

VP

Phone

(954) 981-4822

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1669632857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N 62ND AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247857",
            "telephone_number": "954-981-4822",
            "fax_number": "954-963-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N 62ND AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247857",
            "telephone_number": "954-981-4822",
            "fax_number": "954-963-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PARK RETIREMENT RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "KULNICK",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "954-981-4822",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL6653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "693228200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Hollywood, FL
• Providers in Hollywood, 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 Jun 11, 2008; 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.