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General NPI Number Information
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NPI Number | 1336477256
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Entity Type | Organization
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Legal Business Name | NORCRIST HOME INC.
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Dates
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Enumeration Date | 12/04/2009
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Last Update Date | 12/04/2009
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Provider Practice Location Address
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Address Line | 542 NW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33136-3269
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Country | US
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Telephone | 305-358-7610
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Fax | 305-631-1476
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Provider Business Mailing Address
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Address Line | 542 NW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33136-3269
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Country | US
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Telephone | 305-358-7610
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Fax | 305-631-1476
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARIA CRISTINA RODRIGUEZ
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Credential |
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Telephone | 305-358-7610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL11671
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL11671
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License Number State | FL
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