- Enrollment id
- O20231010000342
- Enrollment state
- FL
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1598413932
- Multiple npi flag
- N
- Ccn
- 105336
- Associate id
- 0042665119
- Organization name
- PALMS NURSING AND REHAB LLC
- Doing business as name
- PALMS CARE CENTER AND REHAB
- Incorporation date
- 2022-02-11
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- PALMS CARE CENTER AND REHAB
- Affiliation entity name
- FL SNF TRUST
- Affiliation entity id
- 852
- Address line 1
- 3370 NW 47TH TER
- City
- LAUDERDALE LAKES
- State
- FL
- Zip code
- 333196701