Provider Demographics
NPI:1376151571
Name:SILVER PALM ASSISTED LIVING FACILITY LLC
Entity Type:Organization
Organization Name:SILVER PALM ASSISTED LIVING FACILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-299-0357
Mailing Address - Street 1:3970 SW 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7813
Mailing Address - Country:US
Mailing Address - Phone:305-226-1706
Mailing Address - Fax:305-777-8855
Practice Address - Street 1:3970 SW 144TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7813
Practice Address - Country:US
Practice Address - Phone:305-226-1706
Practice Address - Fax:305-777-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility