MEDICARE: FAMILY HOUSE ALF CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL11102	FL

General Provider Information

NPI Number	:	1275771347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HOUSE ALF CORP

Provider Business Mailing Address
First Line	:	3011 NW 52ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3450
Country	:	US
Telephone Number	:	786-344-3316
Fax Number	:	305-635-5708

Provider Business Practice Location Address
First Line	:	3011 NW 52ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-3450
Country	:	US
Telephone Number	:	786-344-3316
Fax Number	:	305-635-5708

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROSALINA VALDEZ
Credential	:
Telephone Number	:	786-344-3316

Provider Enumeration Date	:	01/28/2009
Last Update Date	:	01/28/2009

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