Provider Demographics
NPI:1871944579
Name:ARTIS SENIOR LIVING OF BOCA RATON, LLC
Entity type:Organization
Organization Name:ARTIS SENIOR LIVING OF BOCA RATON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-372-0180
Mailing Address - Street 1:5910 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-3935
Mailing Address - Country:US
Mailing Address - Phone:561-989-9945
Mailing Address - Fax:
Practice Address - Street 1:5910 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-3935
Practice Address - Country:US
Practice Address - Phone:561-989-9945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARTIS HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-24
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12835311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)