Healthcare Provider Details

I. General information

NPI: 1598030272
Provider Name (Legal Business Name): ADULT DAY CARE FAMILY DREAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2012
Last Update Date: 03/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3753 NE 163RD ST
NORTH MIAMI BEACH FL
33160-4104
US

IV. Provider business mailing address

3753 NE 163RD ST
NORTH MIAMI BEACH FL
33160-4104
US

V. Phone/Fax

Practice location:
  • Phone: 305-948-0233
  • Fax: 305-948-0234
Mailing address:
  • Phone: 305-948-0233
  • Fax: 305-948-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9193
License Number StateFL

VIII. Authorized Official

Name: ANA FRESNO
Title or Position: OWNER OPERATOR
Credential:
Phone: 305-948-0233