Provider Demographics
NPI:1043835416
Name:ABUELO EUSEBIO ALF CORPORATION
Entity Type:Organization
Organization Name:ABUELO EUSEBIO ALF CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYUVA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-402-1220
Mailing Address - Street 1:28361 SW 158TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1107
Mailing Address - Country:US
Mailing Address - Phone:786-339-9378
Mailing Address - Fax:786-339-9378
Practice Address - Street 1:28361 SW 158TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1107
Practice Address - Country:US
Practice Address - Phone:786-339-9378
Practice Address - Fax:786-339-9378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility