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General NPI Number Information
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NPI Number | 1912150004
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Entity Type | Organization
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Legal Business Name | WISE YEARS ALF INC
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 20229 SW 85TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33189-2523
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Country | US
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Telephone | 305-969-7119
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Fax | 305-969-7119
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Provider Business Mailing Address
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Address Line | 20229 SW 85TH CT
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City | CUTLER BAY
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State | FL
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Zip | 33189-2523
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Country | US
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Telephone | 305-969-7119
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Fax | 305-969-7119
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENILDA MENENDEZ
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Credential |
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Telephone | 305-969-7119
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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 | AL11296
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License Number State | FL
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