CHRISTALLIS MANOR II LLC (NPI# 1528686672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528686672 |
| Entity Type | Organization |
| Organization Name | CHRISTALLIS MANOR II LLC |
| Practice Address |
819 N 31st Ct Hollywood FL 33021-6111 |
| Practice Telephone | 9542745573 |
| Mailing Telephone | 9542745573 |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | AMPARO M DIERKING (OWNER) |
| Authorized Official Telephone | 9542745573 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Christallis Manor II LLC | Former Legal Business Name - Organization |
| Street Address |
819 N 31ST CT |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021-6111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763521 | Lifestyle Living LLC | Assisted Living Facility | 3513 Polk St, Hollywood, FL 33021-6811 | 2020-09-04 |
| 1346715257 | Mst Housing, LLC | Assisted Living Facility | 2525 Pierce St, Hollywood, FL 33020-4393 | 2018-10-06 |
| 1508349838 | Evita King | Assisted Living Facility | 2233 Mckinley St, Hollywood, FL 33020-3054 | 2018-09-12 |
| 1780034652 | Newport Home Care, Inc | Assisted Living Facility | 2811 Cleveland St, Hollywood, FL 33020-2928 | 2016-06-21 |
| 1033525928 | Y & G Enterprises,inc | Assisted Living Facility | 1835 Wilson St, Hollywood, FL 33020-2725 | 2014-07-11 |
| 1932511755 | Nova Palms Alf Inc | Assisted Living Facility | 1600 Taft St, Alf Unit, Hollywood, FL 33020-3272 | 2014-05-28 |
| 1417374489 | Loucasada Noel | Assisted Living Facility | 2003 Fletcher St, Hollywood, FL 33020-6317 | 2014-03-27 |
| 1710302740 | Vandor Geriatric Homecare Inc. | Assisted Living Facility | 2110 N 46th Ave, Hollywood, FL 33021-4161 | 2014-02-27 |
| 1720413206 | Buckingham Place LLC | Assisted Living Facility | 1845 Garfield St, Hollywood, FL 33020-3115 | 2013-09-04 |
| 1124452883 | Holy Garden Alf, Inc | Assisted Living Facility | 2904 N 36th Ave, Hollywood, FL 33021-1391 | 2013-08-29 |
| Find all providers in HOLLYWOOD | ||||
Please comment or provide details below to improve the information on CHRISTALLIS MANOR II LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.