Provider Demographics
NPI:1659797660
Name:AMMI ELDERLY SERVICES INC
Entity Type:Organization
Organization Name:AMMI ELDERLY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEREZ DE FUEGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-216-2017
Mailing Address - Street 1:12431 SW 189TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-3824
Mailing Address - Country:US
Mailing Address - Phone:786-216-2017
Mailing Address - Fax:
Practice Address - Street 1:12431 SW 189TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-3824
Practice Address - Country:US
Practice Address - Phone:786-216-2017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12474310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility