Provider Demographics
NPI:1326505645
Name:LA COLONIA IV ALF, INC
Entity Type:Organization
Organization Name:LA COLONIA IV ALF, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-763-7274
Mailing Address - Street 1:2704 NW 45TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-8015
Mailing Address - Country:US
Mailing Address - Phone:305-763-7274
Mailing Address - Fax:239-673-6545
Practice Address - Street 1:2704 NW 45TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-8015
Practice Address - Country:US
Practice Address - Phone:305-763-7274
Practice Address - Fax:239-673-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility