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General NPI Number Information
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NPI Number | 1801260443
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Entity Type | Organization
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Legal Business Name | CRESCENT ADULT DAY CARE INC.
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 1550 W. 84TH ST. #65
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City | HIALEAH
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State | FL
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Zip | 33014
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Country | US
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Telephone | 305-456-2098
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Fax | 305-456-1157
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Provider Business Mailing Address
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Address Line | 1550 W. 84TH ST. #65
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City | HIALEAH
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State | FL
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Zip | 33014
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Country | US
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Telephone | 305-456-2098
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Fax | 305-456-1157
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Authorized Official
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Title or Position | OWNER/ADMIN
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Name | MERCEDES BARROSO
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Credential |
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Telephone | 786-587-2758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 9340
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License Number State | FL
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