Provider Demographics
NPI:1043763238
Name:SANCAN ALF, INC C/O JOAN SUCKIE-WILIAMS
Entity Type:Organization
Organization Name:SANCAN ALF, INC C/O JOAN SUCKIE-WILIAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENER /
Authorized Official - Prefix:
Authorized Official - First Name:JOAN SUCKIE-WILLIAMS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUCKIE-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-653-4436
Mailing Address - Street 1:50 NW 184TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4512
Mailing Address - Country:US
Mailing Address - Phone:305-653-4436
Mailing Address - Fax:305-653-4436
Practice Address - Street 1:50 NW 184TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4512
Practice Address - Country:US
Practice Address - Phone:305-653-4436
Practice Address - Fax:305-653-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL118913104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness