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General NPI Number Information
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NPI Number | 1073140646
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Entity Type | Organization
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Legal Business Name | ELOHIM ADONAI HOME INC
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 20121 NW 43RD AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-1501
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Country | US
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Telephone | 786-565-9625
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Fax |
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Provider Business Mailing Address
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Address Line | 20121 NW 43RD AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-1501
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Country | US
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Telephone | 786-565-9625
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | IDALYS MARTINEZ
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Credential | OWNER
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Telephone | 786-565-9625
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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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