Provider Demographics
NPI:1609536663
Name:ANA'S FAMILY HOME ALF, INC.
Entity Type:Organization
Organization Name:ANA'S FAMILY HOME ALF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-457-6501
Mailing Address - Street 1:11750 SW 192ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3921
Mailing Address - Country:US
Mailing Address - Phone:305-234-3568
Mailing Address - Fax:305-235-4881
Practice Address - Street 1:11750 SW 192ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-3921
Practice Address - Country:US
Practice Address - Phone:305-234-3568
Practice Address - Fax:305-235-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9779OtherAHCA