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General NPI Number Information
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NPI Number | 1164762795
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Entity Type | Organization
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Legal Business Name | ENDLESS YEARS ADULT CARE CENTER
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 5931 N.W. 173 DR. UNIT 11
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City | MIAMI
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State | FL
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Zip | 33015
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Country | US
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Telephone | 305-558-8740
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Fax | 305-828-3941
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Provider Business Mailing Address
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Address Line | 5931 NW 173RD DR UNIT 11
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City | HIALEAH
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State | FL
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Zip | 33015-5107
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Country | US
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Telephone | 786-295-7036
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Fax | 305-828-3941
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MARLENE LAGE
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Credential |
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Telephone | 786-295-7036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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