Provider Demographics
NPI:1154765774
Name:SWAANNE HOLDINGS, LLC
Entity type:Organization
Organization Name:SWAANNE HOLDINGS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANEITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-993-5082
Mailing Address - Street 1:4180 CORAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2353
Mailing Address - Country:US
Mailing Address - Phone:954-752-1486
Mailing Address - Fax:954-752-1486
Practice Address - Street 1:4180 CORAL SPRINGS DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-2353
Practice Address - Country:US
Practice Address - Phone:954-752-1486
Practice Address - Fax:954-752-1486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10429310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility