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General NPI Number Information
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NPI Number | 1366912032
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Entity Type | Organization
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Legal Business Name | ALF LUCIA LLC
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 5317 SW 92ND AVE
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City | MIAMI
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State | FL
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Zip | 33165-6532
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Country | US
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Telephone | 786-320-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 5317 SW 92ND AVE
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City | MIAMI
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State | FL
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Zip | 33165-6532
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Country | US
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Telephone | 786-320-3376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALBERTO VIOLA
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Credential |
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Telephone | 786-320-3376
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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 |
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License Number State |
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