Provider Demographics
NPI:1114500519
Name:AMOR Y VIDA ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:AMOR Y VIDA ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-332-3683
Mailing Address - Street 1:2150 W 76TH ST STE 102-106
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1882
Mailing Address - Country:US
Mailing Address - Phone:786-332-3683
Mailing Address - Fax:786-332-3972
Practice Address - Street 1:2150 W 76TH ST STE 102-106
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1882
Practice Address - Country:US
Practice Address - Phone:786-332-3683
Practice Address - Fax:786-332-3972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care