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General NPI Number Information
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NPI Number | 1508454182
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Entity Type | Organization
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Legal Business Name | ADULT LIFE CARE CENTER INC
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 11246 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 786-631-5999
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Fax | 786-580-5189
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Provider Business Mailing Address
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Address Line | 11246 SW 137TH AVE
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City | MIAMI
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State | FL
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Zip | 33186
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Country | US
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Telephone | 786-631-5999
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Fax | 786-580-5189
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Authorized Official
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Title or Position | OWNER
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Name | YANET RODRIGUEZ
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Credential |
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Telephone | 305-821-1613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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