Provider Demographics
NPI:1124206545
Name:MAJESTIC CARE GROUP HOME, INC.
Entity Type:Organization
Organization Name:MAJESTIC CARE GROUP HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANILO
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:ALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-798-8979
Mailing Address - Street 1:18055 SW 154TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-6260
Mailing Address - Country:US
Mailing Address - Phone:305-256-4376
Mailing Address - Fax:
Practice Address - Street 1:18055 SW 154TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-6260
Practice Address - Country:US
Practice Address - Phone:305-256-4376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11792GH3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness