Provider Demographics
NPI:1720431067
Name:VICTORIA GARDEN ALF, INC.
Entity type:Organization
Organization Name:VICTORIA GARDEN ALF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-207-3198
Mailing Address - Street 1:550 OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2216
Mailing Address - Country:US
Mailing Address - Phone:786-547-4222
Mailing Address - Fax:
Practice Address - Street 1:3091 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33309-4310
Practice Address - Country:US
Practice Address - Phone:786-547-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106313104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness