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NPI Code Detail

MEDICARE: NEW AGE ADULTCARE

MEDICARE: NEW AGE ADULTCARE
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
1310400000XAssisted Living Facility12526FL

General Provider Information

NPI Number : 1942615000
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW AGE ADULTCARE
Provider Business Mailing Address
First Line : 1105 W 2ND AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33010-3802
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1105 W 2ND AVE
Second Line :
City : HIALEAH
State : FL
Zip : 33010-3802
Country : US
Telephone Number : 786-477-0464
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DAMIAN HURTADO
Credential :
Telephone Number : 786-477-0464
Provider Enumeration Date : 06/27/2014
Last Update Date : 06/27/2014

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Directions to “NEW AGE ADULTCARE ” Practice Location

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