Provider Demographics
NPI:1164762795
Name:ENDLESS YEARS ADULT CARE CENTER
Entity Type:Organization
Organization Name:ENDLESS YEARS ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-295-7036
Mailing Address - Street 1:5931 NW 173RD DR UNIT 11
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5107
Mailing Address - Country:US
Mailing Address - Phone:786-295-7036
Mailing Address - Fax:305-828-3941
Practice Address - Street 1:5931 N.W. 173 DR.
Practice Address - Street 2:UNIT 11
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33015
Practice Address - Country:US
Practice Address - Phone:305-558-8740
Practice Address - Fax:305-828-3941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care