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General NPI Number Information
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NPI Number | 1861689713
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Entity Type | Organization
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Legal Business Name | ABUELITOS FELICES, ALF INC.
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 12744 SW 204TH ST.
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City | MIAMI
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State | FL
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Zip | 33177
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Country | US
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Telephone | 786-293-8393
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Fax | 786-293-8393
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Provider Business Mailing Address
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Address Line | 12744 SW 204TH ST.
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City | MIAMI
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State | FL
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Zip | 33177
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Country | US
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Telephone | 786-293-8393
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Fax | 786-293-8393
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Authorized Official
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Title or Position | VICE-PRESIDENTE/ ADMINISTRATOR
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Name | MRS. BLANCA M. MILANES
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Credential |
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Telephone | 786-543-0507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL11076
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License Number State | FL
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