=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891092599
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CASA SALCINES A.L.F.II, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2011
-----------------------------------------------------
Last Update Date | 02/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8911 SW 157TH ST
-----------------------------------------------------
City | PALMETTO BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-1937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-256-1765
-----------------------------------------------------
Fax | 305-256-1766
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8911 SW 157TH ST
-----------------------------------------------------
City | PALMETTO BAY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-1937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-256-1765
-----------------------------------------------------
Fax | 305-256-1766
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. BERTA SALCINES JAFFE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 305-256-1765
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number | AL11949
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------