Provider Demographics
NPI:1558804344
Name:MIS ABUELOS ADULT DAY CARE, LLC
Entity Type:Organization
Organization Name:MIS ABUELOS ADULT DAY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SISI
Authorized Official - Middle Name:
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-286-6860
Mailing Address - Street 1:8298 BIRD RD
Mailing Address - Street 2:STE 101-102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3335
Mailing Address - Country:US
Mailing Address - Phone:786-286-6860
Mailing Address - Fax:
Practice Address - Street 1:8298 BIRD RD
Practice Address - Street 2:STE 101-102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3335
Practice Address - Country:US
Practice Address - Phone:786-286-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care