Healthcare Provider Details

I. General information

NPI: 1780588145
Provider Name (Legal Business Name): CASA DE AMOR ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HORSESHOE CT
KISSIMMEE FL
34743-7529
US

IV. Provider business mailing address

2 HORSESHOE CT
KISSIMMEE FL
34743-7529
US

V. Phone/Fax

Practice location:
  • Phone: 407-953-4973
  • Fax:
Mailing address:
  • Phone: 407-953-4973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: IRENE SANTIAGO COLON
Title or Position: OWNER
Credential:
Phone: 407-953-4973