Provider Demographics
NPI:1134668270
Name:JANUA COELI INC.
Entity Type:Organization
Organization Name:JANUA COELI INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUESCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-774-9590
Mailing Address - Street 1:281 SW 48TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1264
Mailing Address - Country:US
Mailing Address - Phone:305-774-9590
Mailing Address - Fax:
Practice Address - Street 1:281 SW 48TH CT
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1264
Practice Address - Country:US
Practice Address - Phone:305-774-9590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12913310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility