Healthcare Provider Details

I. General information

NPI: 1124610373
Provider Name (Legal Business Name): FAMILIA ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5951 NW 173RD DR # B10
HIALEAH FL
33015-5112
US

IV. Provider business mailing address

3440 W 100TH TER
HIALEAH FL
33018-2103
US

V. Phone/Fax

Practice location:
  • Phone: 305-923-2159
  • Fax:
Mailing address:
  • Phone: 305-298-1043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAEL CUE
Title or Position: PRESIDENT
Credential:
Phone: 305-923-2159