Provider Demographics
NPI:1396010633
Name:NANCY'S ADULT FAMILY CARE
Entity type:Organization
Organization Name:NANCY'S ADULT FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATIVE
Authorized Official - Phone:954-476-7185
Mailing Address - Street 1:7660 NW 12TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-4702
Mailing Address - Country:US
Mailing Address - Phone:954-476-7185
Mailing Address - Fax:954-476-1181
Practice Address - Street 1:7660 NW 12TH CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-4702
Practice Address - Country:US
Practice Address - Phone:954-476-7185
Practice Address - Fax:954-476-1181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11012320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities