MEDICARE: CARTAYA GROUP HOME, CORP

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780273821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTAYA GROUP HOME, CORP

Provider Business Mailing Address
First Line	:	7420 N OAKMONT DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2071
Country	:	US
Telephone Number	:	786-712-9610
Fax Number	:

Provider Business Practice Location Address
First Line	:	7420 N OAKMONT DR
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-2071
Country	:	US
Telephone Number	:	786-712-9610
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARAH SERRANO CARTAYA
Credential	:
Telephone Number	:	786-712-9610

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	01/13/2021

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Directions to “CARTAYA GROUP HOME, CORP ” Practice Location

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