FORT LAUDERDALE RETIREMENT HOME
NPI 1568880565
Assisted Living Facility - Assisted Living, Mental Illness in Fort Lauderdale, FL

Q: What is 2065 Inc Dba Fort Lauderdale Retirement Home's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Active since April 07, 2014

401 SE 12TH CT, FORT LAUDERDALE, FL 33316(954) 270-6322(954) 423-1674 Get Directions Write a Review

NPPES record last updated: April 7, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Fort Lauderdale Retirement Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FORT LAUDERDALE RETIREMENT HOME (NPI 1568880565) is a healthcare organization registered as an assisted living, mental illness in Fort Lauderdale, Florida and active in the NPI registry since April 2014. The organization lists Jackie Henry Heath, Administrator/owner, as its authorized official.

NPPES Registry Identity

NPI1568880565

Entity TypeOrganization

Primary Taxonomy3104A0625X

Legal Business Name2065 INC DBA FORT LAUDERDALE RETIREMENT HOME

Location Address401 SE 12TH CTFort Lauderdale, FL 33316-1919

Mailing Address401 Se 12th CtFort Lauderdale, FL 33316-1919 · (954) 270-6322 · Fax (954) 423-1674

Phone(954) 270-6322

Fax(954) 423-1674

Organization SubpartNo

Authorized OfficialJackie Henry HeathAdministrator/owner · (954) 270-6322

Enumeration DateApril 7, 2014

✔ NPI 1568880565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code3104A0625X

License✔ Licensed in FL · ALF6634

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.

401 SE 12TH CT, Fort Lauderdale, FL 33316

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Other Names 1

Doing Business AsFort Lauderdale Retirement Home

Other Identifiers 1

Medicaid140290100FL

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 2065 Inc Dba Fort Lauderdale Retirement Home's NPI number?

The NPI number for 2065 Inc Dba Fort Lauderdale Retirement Home is 1568880565. It was assigned to this organization in the NPPES registry on April 7, 2014. The provider is doing business as Fort Lauderdale Retirement Home.

Where is 2065 Inc Dba Fort Lauderdale Retirement Home located?

2065 Inc Dba Fort Lauderdale Retirement Home is located at 401 SE 12th Ct, Fort Lauderdale, FL 33316. The listed phone number is (954) 270-6322.

What is 2065 Inc Dba Fort Lauderdale Retirement Home's specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

When was this NPI record last updated?

The NPPES record for 2065 Inc Dba Fort Lauderdale Retirement Home was last updated on April 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.