Provider Demographics
NPI:1487195558
Name:VILLA ROSA I, INC.
Entity Type:Organization
Organization Name:VILLA ROSA I, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-8095
Mailing Address - Street 1:182 W. 9TH STREET
Mailing Address - Street 2:VILLA ROSA I, INC.
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4015
Mailing Address - Country:US
Mailing Address - Phone:305-887-8095
Mailing Address - Fax:305-887-8014
Practice Address - Street 1:182 W. 9TH STREET
Practice Address - Street 2:VILLA ROSA I, INC.
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4015
Practice Address - Country:US
Practice Address - Phone:305-887-8095
Practice Address - Fax:305-887-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL58493104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness