Provider Demographics
NPI:1578900288
Name:AMANECER ADULT DAY CARE CENTER, INC.
Entity Type:Organization
Organization Name:AMANECER ADULT DAY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORES
Authorized Official - Suffix:
Authorized Official - Credentials:MDY
Authorized Official - Phone:786-362-5770
Mailing Address - Street 1:14550 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184-3132
Mailing Address - Country:US
Mailing Address - Phone:786-362-5770
Mailing Address - Fax:786-362-5337
Practice Address - Street 1:14550 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-3132
Practice Address - Country:US
Practice Address - Phone:786-362-5770
Practice Address - Fax:786-362-5337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9244261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9244OtherAHCA STATE LICENSE