Healthcare Provider Details

I. General information

NPI: 1437459377
Provider Name (Legal Business Name): NORLAND GARDENS INC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19615 NW 12TH CT
MIAMI FL
33169-3080
US

IV. Provider business mailing address

19615 NW 12TH CT
MIAMI FL
33169-3080
US

V. Phone/Fax

Practice location:
  • Phone: 305-653-0918
  • Fax: 305-653-1720
Mailing address:
  • Phone: 305-653-0918
  • Fax: 305-653-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. EUFRACIA URENA
Title or Position: PRESIDENT
Credential: RN
Phone: 305-653-0918