Healthcare Provider Details

I. General information

NPI: 1114307550
Provider Name (Legal Business Name): ELDER'S PLACE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12318 QUAIL ROOST DR
MIAMI FL
33177-4930
US

IV. Provider business mailing address

12318 QUAIL ROOST DR
MIAMI FL
33177-4930
US

V. Phone/Fax

Practice location:
  • Phone: 786-708-7607
  • Fax:
Mailing address:
  • Phone: 786-708-7607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9317
License Number StateFL

VIII. Authorized Official

Name: MRS. NATASHA MELENDEZ
Title or Position: CEO
Credential:
Phone: 786-348-6156