MEDICARE: JENE'S RETIREMENT LIVING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	AL5934	FL
2	3104A0625X	Assisted Living Facility (Mental Illness)	AL5934	FL

General Provider Information

NPI Number	:	1699977082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENE'S RETIREMENT LIVING, INC.

Provider Business Mailing Address
First Line	:	140 W 28TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-1606
Country	:	US
Telephone Number	:	305-863-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1595 NE 145TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33161-3024
Country	:	US
Telephone Number	:	305-947-3416
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	CLAUDIA PACE
Credential	:
Telephone Number	:	305-863-0002

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	09/11/2025

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