Provider Demographics
NPI:1275756090
Name:VIP CARE PAVILION LTD.
Entity type:Organization
Organization Name:VIP CARE PAVILION LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:COLTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-971-2286
Mailing Address - Street 1:6810 S.W. 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-0000
Mailing Address - Country:US
Mailing Address - Phone:954-971-2286
Mailing Address - Fax:954-975-3523
Practice Address - Street 1:6810 S.W. 7TH STREET
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33068-0000
Practice Address - Country:US
Practice Address - Phone:954-971-2286
Practice Address - Fax:954-975-3523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL4783311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)