Provider Demographics
NPI:1225580228
Name:MUGICA GROUP HOME, INC.
Entity Type:Organization
Organization Name:MUGICA GROUP HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NORAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-768-8556
Mailing Address - Street 1:9860 CARIBBEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1572
Mailing Address - Country:US
Mailing Address - Phone:786-768-8556
Mailing Address - Fax:786-732-4562
Practice Address - Street 1:9860 CARIBBEAN BLVD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1572
Practice Address - Country:US
Practice Address - Phone:786-768-8556
Practice Address - Fax:786-732-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services