Basic Information
| Provider Information | |||||||||
| NPI: | 1386796217 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOSEPH L MORSE HEALTH CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4847 DAVID S MACK DR | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334178023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614715111 | ||||||||
| FaxNumber: | 5616898718 | ||||||||
| Practice Location | |||||||||
| Address1: | 4847 DAVID S MACK DR | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334178023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614715111 | ||||||||
| FaxNumber: | 5616898718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2007 | ||||||||
| LastUpdateDate: | 02/20/2019 | ||||||||
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| AuthorizedOfficialLastName: | WOLAN | ||||||||
| AuthorizedOfficialFirstName: | RANDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 5612096108 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | SNF1261096 | FL | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 020738100 | 05 | FL | MEDICAID |