Healthcare Provider Details

I. General information

NPI: 1598188278
Provider Name (Legal Business Name): SWEET HOME ADULT RESIDENTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13562 SW 38TH LN
MIAMI FL
33175-3214
US

IV. Provider business mailing address

13562 SW 38TH LN
MIAMI FL
33175-3214
US

V. Phone/Fax

Practice location:
  • Phone: 305-552-9789
  • Fax:
Mailing address:
  • Phone: 305-552-9789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9214
License Number StateFL

VIII. Authorized Official

Name: SARA Z GONZALEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-552-9789