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General NPI Number Information
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NPI Number | 1326505645
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Entity Type | Organization
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Legal Business Name | LA COLONIA IV ALF, INC
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Dates
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Enumeration Date | 02/22/2019
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 2704 NW 45TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33993-8015
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Country | US
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Telephone | 305-763-7274
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Fax | 239-673-6545
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Provider Business Mailing Address
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Address Line | 2704 NW 45TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33993-8015
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Country | US
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Telephone | 305-763-7274
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Fax | 239-673-6545
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. MILAGROS TORRES
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Credential |
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Telephone | 305-763-7274
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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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