Provider Demographics
NPI:1326482621
Name:RESIDENCIA CASABELLA ALF CORP.
Entity Type:Organization
Organization Name:RESIDENCIA CASABELLA ALF CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-406-3777
Mailing Address - Street 1:8324 NW 195TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5944
Mailing Address - Country:US
Mailing Address - Phone:305-829-1504
Mailing Address - Fax:786-452-0996
Practice Address - Street 1:8324 NW 195TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5944
Practice Address - Country:US
Practice Address - Phone:305-829-1504
Practice Address - Fax:786-452-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL123453104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances