Provider Demographics
NPI:1326297797
Name:NUESTRO HOGAR ALF INC
Entity Type:Organization
Organization Name:NUESTRO HOGAR ALF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CELORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-252-6818
Mailing Address - Street 1:9384 SW 184TH TER
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7032
Mailing Address - Country:US
Mailing Address - Phone:786-252-6818
Mailing Address - Fax:786-252-6818
Practice Address - Street 1:9384 SW 184TH TER
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7032
Practice Address - Country:US
Practice Address - Phone:786-252-6818
Practice Address - Fax:786-252-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10905310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142706700Medicaid