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General NPI Number Information
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NPI Number | 1013328665
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Entity Type | Organization
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Legal Business Name | LA CASA DE TODOS INC.
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 2364 W LAKEWOOD RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-3173
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Country | US
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Telephone | 561-294-2197
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Fax |
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Provider Business Mailing Address
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Address Line | 2364 W LAKEWOOD RD
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-3173
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Country | US
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Telephone | 561-294-2197
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RAUL J PEREZ MOLINA
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Credential |
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Telephone | 561-225-1085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 12504
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License Number State | FL
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