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General NPI Number Information
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NPI Number | 1225295082
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Entity Type | Organization
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Legal Business Name | DA LOURDES SERVICES CORP
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15605 SW 178TH LN
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City | MIAMI
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State | FL
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Zip | 33187-7805
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Country | US
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Telephone | 305-968-7525
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Fax | 305-253-3027
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Provider Business Mailing Address
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Address Line | 15605 SW 178TH LN
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City | MIAMI
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State | FL
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Zip | 33187-7805
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Country | US
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Telephone | 305-968-7525
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Fax | 305-253-3027
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. TERESITA MORENO
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Credential |
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Telephone | 305-968-7525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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