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General NPI Number Information
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NPI Number | 1730340472
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Entity Type | Organization
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Legal Business Name | MEADOW WOOD HOME, LLC.
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 25799 SW 122 PL
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City | HOMESTEAD
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State | FL
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Zip | 33032
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Country | US
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Telephone | 786-481-5980
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Fax | 786-481-5980
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Provider Business Mailing Address
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Address Line | 25799 SW 122 PL
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City | HOMESTEAD
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State | FL
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Zip | 33032
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Country | US
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Telephone | 786-481-5980
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Fax | 786-481-5980
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Authorized Official
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Title or Position | OWNER
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Name | GRACE FRANCO
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Credential |
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Telephone | 786-257-7020
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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 | AL10716
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License Number State | FL
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