Provider Demographics
NPI:1538596507
Name:MEDICANA NURSING & REHAB
Entity type:Organization
Organization Name:MEDICANA NURSING & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHBOUDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-582-5331
Mailing Address - Street 1:1710 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3627
Mailing Address - Country:US
Mailing Address - Phone:561-582-5331
Mailing Address - Fax:561-582-9647
Practice Address - Street 1:1710 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-3627
Practice Address - Country:US
Practice Address - Phone:561-582-5331
Practice Address - Fax:561-582-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1338096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility