Provider Demographics
NPI:1164062600
Name:BRITO'S HOME 3 LLC
Entity Type:Organization
Organization Name:BRITO'S HOME 3 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-853-5569
Mailing Address - Street 1:19059 NW 77TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5257
Mailing Address - Country:US
Mailing Address - Phone:786-565-9090
Mailing Address - Fax:786-320-6165
Practice Address - Street 1:19059 NW 77TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33015-5257
Practice Address - Country:US
Practice Address - Phone:786-565-9090
Practice Address - Fax:786-320-6165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility