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General NPI Number Information
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NPI Number | 1497349450
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Entity Type | Organization
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Legal Business Name | SAINT JOHNS ALF LLC
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Dates
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Enumeration Date | 02/21/2021
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Last Update Date | 02/21/2021
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Provider Practice Location Address
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Address Line | 7580 SW 30TH TER
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City | MIAMI
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State | FL
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Zip | 33155-2750
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Country | US
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Telephone | 786-360-2940
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Fax | 786-615-5676
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Provider Business Mailing Address
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Address Line | 7580 SW 30TH TER
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City | MIAMI
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State | FL
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Zip | 33155-2750
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Country | US
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Telephone | 786-360-2940
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Fax | 786-615-5676
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Authorized Official
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Title or Position | OWNER
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Name | MILAINE M DOMINGUEZ
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Credential |
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Telephone | 786-218-5178
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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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