- Enrollment id
- O20060110001129
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1417949579
- Multiple npi flag
- N
- Ccn
- 106038
- Associate id
- 5698686608
- Organization name
- FLORIDA DEPARTMENT OF VETERANS AFFAIRS
- Doing business as name
- ALEXANDER "SANDY" NININGER STATE VETERANS' NURSING HOME
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- ALEXANDER "SANDY" NININGER STATE VETERANS NURSING
- Address line 1
- 8401 W CYPRESS DR
- City
- PEMBROKE PINES
- State
- FL
- Zip code
- 330254540