Healthcare Provider Details

I. General information

NPI: 1598997157
Provider Name (Legal Business Name): LIVING IN PEACE ALF INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2009
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 NW 178TH ST
MIAMI GARDENS FL
33055-3132
US

IV. Provider business mailing address

5610 NW 178TH ST
MIAMI GARDENS FL
33055-3132
US

V. Phone/Fax

Practice location:
  • Phone: 305-965-0411
  • Fax:
Mailing address:
  • Phone: 305-965-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberAL 11625
License Number StateFL

VIII. Authorized Official

Name: HILDA VALERO
Title or Position: OWNER/ ADMINISTRATOR
Credential:
Phone: 305-965-0411