Provider Demographics
NPI:1639715204
Name:VIDA HOLISTICA ALF CORP.
Entity Type:Organization
Organization Name:VIDA HOLISTICA ALF CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:IVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-302-1332
Mailing Address - Street 1:8721 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6755
Mailing Address - Country:US
Mailing Address - Phone:305-418-0440
Mailing Address - Fax:305-418-0440
Practice Address - Street 1:8721 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-6755
Practice Address - Country:US
Practice Address - Phone:305-418-0440
Practice Address - Fax:305-418-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility