Healthcare Provider Details

I. General information

NPI: 1295666469
Provider Name (Legal Business Name): PROMISE OF LOVE GROUP HOME CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15355 SW 171ST ST
MIAMI FL
33187-6769
US

IV. Provider business mailing address

15355 SW 171ST ST
MIAMI FL
33187-6769
US

V. Phone/Fax

Practice location:
  • Phone: 786-447-3460
  • Fax:
Mailing address:
  • Phone: 786-447-3460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MAIDE FIGUEREDO
Title or Position: HOME OPERATOR
Credential: MEDICAID PROVIDER
Phone: 786-447-3460