Provider Demographics
NPI:1104084318
Name:ALTERRA HEALTHCARE
Entity type:Organization
Organization Name:ALTERRA HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-287-6001
Mailing Address - Street 1:3401 SE ASTER LN
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-5533
Mailing Address - Country:US
Mailing Address - Phone:772-287-6001
Mailing Address - Fax:772-287-9191
Practice Address - Street 1:3401 SE ASTER LN
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-5533
Practice Address - Country:US
Practice Address - Phone:772-287-6001
Practice Address - Fax:772-287-9191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALE SENIOR LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8773310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility