Provider Demographics
NPI:1700218328
Name:SPECIAL LOVING HOME, INC.
Entity Type:Organization
Organization Name:SPECIAL LOVING HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNE/RADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARMEL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JEAN-POIX
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:754-484-7042
Mailing Address - Street 1:652 NW 113TH TER
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7977
Mailing Address - Country:US
Mailing Address - Phone:754-484-7042
Mailing Address - Fax:754-484-7042
Practice Address - Street 1:652 NW 113TH TER
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7977
Practice Address - Country:US
Practice Address - Phone:754-484-7042
Practice Address - Fax:754-484-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12246310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility