Provider Demographics
NPI:1215377221
Name:NUEVO HORIZONTE ASSISTED LIVING FACILITY, INC.
Entity Type:Organization
Organization Name:NUEVO HORIZONTE ASSISTED LIVING FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-817-1379
Mailing Address - Street 1:8111 N OLA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-2923
Mailing Address - Country:US
Mailing Address - Phone:813-935-4709
Mailing Address - Fax:813-933-1237
Practice Address - Street 1:8111 N OLA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-2923
Practice Address - Country:US
Practice Address - Phone:813-935-4709
Practice Address - Fax:813-933-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11754310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility