Provider Demographics
NPI:1093992265
Name:CASA LLANES II ALF, INC
Entity Type:Organization
Organization Name:CASA LLANES II ALF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASASUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-364-7169
Mailing Address - Street 1:374 E 50TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1519
Mailing Address - Country:US
Mailing Address - Phone:305-364-7169
Mailing Address - Fax:
Practice Address - Street 1:374 E 50TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1519
Practice Address - Country:US
Practice Address - Phone:305-364-7169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10521310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility