Healthcare Provider Details

I. General information

NPI: 1164762795
Provider Name (Legal Business Name): ENDLESS YEARS ADULT CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5931 N.W. 173 DR. UNIT 11
MIAMI FL
33015
US

IV. Provider business mailing address

5931 NW 173RD DR UNIT 11
HIALEAH FL
33015-5107
US

V. Phone/Fax

Practice location:
  • Phone: 305-558-8740
  • Fax: 305-828-3941
Mailing address:
  • Phone: 786-295-7036
  • Fax: 305-828-3941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARLENE LAGE
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 786-295-7036