Basic Information
| Provider Information | |||||||||
| NPI: | 1497009336 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WHITEHALL OF BOCA RATON, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WHITEHALL BOCA RATON | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6 CADILLAC DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152507100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7300 DEL PRADO CIR S | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334333386 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613923000 | ||||||||
| FaxNumber: | 5613926031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/30/2012 | ||||||||
| LastUpdateDate: | 10/30/2012 | ||||||||
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| AuthorizedOfficialLastName: | ORAND | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6152507100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.