Healthcare Provider Details

I. General information

NPI: 1891238572
Provider Name (Legal Business Name): ADULT DAY CARE WELLNESS & OUTREACH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 NE 1 ST ROAD UNIT B
HOMESTEAD FL
33030
US

IV. Provider business mailing address

17 NE 1 ST ROAD UNIT B
HOMESTEAD FL
33030
US

V. Phone/Fax

Practice location:
  • Phone: 786-566-1612
  • Fax:
Mailing address:
  • Phone: 786-566-1612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. WALLEM HERNANDEZ
Title or Position: OWNER
Credential:
Phone: 786-566-1612