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General NPI Number Information
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NPI Number | 1528279411
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Entity Type | Organization
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Legal Business Name | ADVANCE ALF CORP.
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 14335 S.W. 288TH STREET
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City | HOMESTEAD
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State | FL
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Zip | 33033
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Country | US
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Telephone | 786-417-0336
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Fax | 786-339-8991
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Provider Business Mailing Address
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Address Line | 14335 S.W. 288TH STREET
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City | HOMESTEAD
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State | FL
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Zip | 33033
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Country | US
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Telephone | 786-586-4524
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Fax | 305-225-1289
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Authorized Official
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Title or Position | OWNER
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Name | RAFAEL GOLAN
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Credential |
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Telephone | 786-417-0336
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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 | AL10348
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License Number State | FL
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