Healthcare Provider Details

I. General information

NPI: 1215509443
Provider Name (Legal Business Name): VIVE FELIZ ADULT DAYCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1541 SE 12TH AVE STE 32-3334
HOMESTEAD FL
33034-2699
US

IV. Provider business mailing address

1541 SE 12TH AVE STE 32-3334
HOMESTEAD FL
33034-2699
US

V. Phone/Fax

Practice location:
  • Phone: 786-404-3685
  • Fax: 786-404-3685
Mailing address:
  • Phone: 786-404-3685
  • Fax: 786-404-3685

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: MARIA A CHILS
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 786-780-4648