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General NPI Number Information
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NPI Number | 1235376930
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Entity Type | Organization
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Legal Business Name | LIVING WELL ALF CORP
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 01/16/2009
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Provider Practice Location Address
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Address Line | 21280 OLD CUTLER RD
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City | CUTLER BAY
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State | FL
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Zip | 33189-3131
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Country | US
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Telephone | 305-431-2586
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Fax | 305-229-0091
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Provider Business Mailing Address
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Address Line | 21280 OLD CUTLER RD
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City | CUTLER BAY
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State | FL
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Zip | 33189-3131
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Country | US
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Telephone | 305-431-2586
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Fax | 305-229-0091
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Authorized Official
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Title or Position | V PRESIDENTE
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Name | JORGE E GACEL
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Credential |
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Telephone | 305-431-2586
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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 | AL11461
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License Number State | FL
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