Basic Information
Provider Information
NPI: 1467478719
EntityType: 2
ReplacementNPI:  
OrganizationName: HRNC, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BROOKWOOD GARDENS REHABILITATION AND NURSING CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2979 PGA BLVD
Address2:  
City: PALM BEACH GARDENS
State: FL
PostalCode: 334102911
CountryCode: US
TelephoneNumber: 5616270664
FaxNumber: 5616272867
Practice Location
Address1: 1990 S CANAL DR
Address2:  
City: HOMESTEAD
State: FL
PostalCode: 330351046
CountryCode: US
TelephoneNumber: 3052461200
FaxNumber: 3052469570
Other Information
ProviderEnumerationDate: 07/13/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: KLEISER
AuthorizedOfficialFirstName: JULIE
AuthorizedOfficialMiddleName: C.
AuthorizedOfficialTitleorPosition: AUDIT & REIMBURSEMENT SR. ANALYST
AuthorizedOfficialTelephone: 5616270664
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000XSNF 1064096FLY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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