Provider Demographics
NPI:1902442916
Name:ATLANTIS SENIOR CARE, LLC
Entity type:Organization
Organization Name:ATLANTIS SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SUHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-789-7924
Mailing Address - Street 1:10515 VERSAILLES BLVD
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8084
Mailing Address - Country:US
Mailing Address - Phone:561-789-7924
Mailing Address - Fax:
Practice Address - Street 1:460 NW 40TH CT
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-5138
Practice Address - Country:US
Practice Address - Phone:954-990-8857
Practice Address - Fax:954-440-4761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)