Provider Demographics
NPI:1497307631
Name:SAGRADO CORAZON ALF CORP.
Entity Type:Organization
Organization Name:SAGRADO CORAZON ALF CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:ESTELA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRUTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-761-3216
Mailing Address - Street 1:4051 SW 95TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-5239
Mailing Address - Country:US
Mailing Address - Phone:786-353-2227
Mailing Address - Fax:786-353-2227
Practice Address - Street 1:4051 SW 95TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5239
Practice Address - Country:US
Practice Address - Phone:786-353-2227
Practice Address - Fax:786-353-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility