Provider Demographics
NPI:1003013962
Name:OUR FAMILY ASSISTED LIVING FACILITY, INC.
Entity Type:Organization
Organization Name:OUR FAMILY ASSISTED LIVING FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEIBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-597-4695
Mailing Address - Street 1:153 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-4446
Mailing Address - Country:US
Mailing Address - Phone:786-597-4695
Mailing Address - Fax:
Practice Address - Street 1:153 NW 26TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-4446
Practice Address - Country:US
Practice Address - Phone:786-597-4695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10952310400000X, 3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness