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General NPI Number Information
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NPI Number | 1871749077
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Entity Type | Organization
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Legal Business Name | WEST MIAMI ADULT LIVING FACILITY, INC
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 7215 SW 21ST ST
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City | MIAMI
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State | FL
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Zip | 33155-1472
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Country | US
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Telephone | 305-300-7721
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Fax | 305-223-2371
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Provider Business Mailing Address
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Address Line | 7215 SW 21ST ST
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City | MIAMI
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State | FL
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Zip | 33155-1472
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Country | US
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Telephone | 305-300-7721
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Fax | 305-223-2371
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | BELKIS VILLALBA
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Credential |
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Telephone | 305-300-7721
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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 | AL10925
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License Number State | FL
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