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General NPI Number Information
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NPI Number | 1245679588
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Entity Type | Organization
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Legal Business Name | LONG LIFE ADULT DAYCARE
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 5995 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-5037
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Country | US
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Telephone | 786-384-9482
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Fax |
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Provider Business Mailing Address
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Address Line | 5995 SW 8TH ST
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City | WEST MIAMI
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State | FL
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Zip | 33144-5037
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Country | US
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Telephone | 786-384-9482
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARJORIE RODRIGUEZ
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Credential |
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Telephone | 786-384-9482
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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 | 9245
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License Number State | FL
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