Provider Demographics
NPI:1316361892
Name:MIS ABUELITOS FELICES ADULT DAY CARE, INC
Entity Type:Organization
Organization Name:MIS ABUELITOS FELICES ADULT DAY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-542-0561
Mailing Address - Street 1:15260 SW 280TH ST
Mailing Address - Street 2:BAY 118-119
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8185
Mailing Address - Country:US
Mailing Address - Phone:305-542-0561
Mailing Address - Fax:
Practice Address - Street 1:15260 SW 280TH ST
Practice Address - Street 2:BAY 118-119
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8185
Practice Address - Country:US
Practice Address - Phone:305-245-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9266261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care