Provider Demographics
NPI:1598188278
Name:SWEET HOME ADULT RESIDENTS INC
Entity Type:Organization
Organization Name:SWEET HOME ADULT RESIDENTS INC
Other - Org Name:MI CASITA ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-552-9789
Mailing Address - Street 1:13562 SW 38TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3214
Mailing Address - Country:US
Mailing Address - Phone:305-552-9789
Mailing Address - Fax:
Practice Address - Street 1:13562 SW 38TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3214
Practice Address - Country:US
Practice Address - Phone:305-552-9789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9214261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care