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General NPI Number Information
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NPI Number | 1033838834
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Entity Type | Organization
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Legal Business Name | GONZALEZ ADULT CARE FACILITIES LLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 228 DATE PALM DR
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City | LAKE PARK
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State | FL
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Zip | 33403-3407
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Country | US
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Telephone | 561-720-2953
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Fax | 561-228-0581
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Provider Business Mailing Address
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Address Line | 228 DATE PALM DR
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City | LAKE PARK
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State | FL
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Zip | 33403-3407
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Country | US
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Telephone | 561-720-2953
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Fax | 561-228-0581
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Authorized Official
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Title or Position | OWNER/ADMIN.
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Name | YOANNERY C GONZALEZ
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Credential |
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Telephone | 561-246-2080
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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 |
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License Number State |
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