Provider Demographics
NPI:1437900859
Name:LITTLE GABLES RETIREMENT HOME
Entity Type:Organization
Organization Name:LITTLE GABLES RETIREMENT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIROGA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:305-281-6839
Mailing Address - Street 1:615 HARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-1703
Mailing Address - Country:US
Mailing Address - Phone:305-281-6839
Mailing Address - Fax:786-497-3407
Practice Address - Street 1:4045 SW 9TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33134-2633
Practice Address - Country:US
Practice Address - Phone:305-281-6839
Practice Address - Fax:786-497-3407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness