Provider Demographics
NPI:1760632186
Name:MAJESTIC SENIOR CARE ALF , INC
Entity Type:Organization
Organization Name:MAJESTIC SENIOR CARE ALF , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZOILA
Authorized Official - Middle Name:E
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-367-6954
Mailing Address - Street 1:15347 SW 179TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-7735
Mailing Address - Country:US
Mailing Address - Phone:786-367-6954
Mailing Address - Fax:786-573-0999
Practice Address - Street 1:15347 SW 179TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-7735
Practice Address - Country:US
Practice Address - Phone:786-367-6954
Practice Address - Fax:786-573-0999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11070310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility