Provider Demographics
NPI:1760793145
Name:LORD FAMILY SERVICE INC
Entity Type:Organization
Organization Name:LORD FAMILY SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEANA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:305-824-8888
Mailing Address - Street 1:2604 W 84TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5703
Mailing Address - Country:US
Mailing Address - Phone:305-824-8888
Mailing Address - Fax:305-824-8854
Practice Address - Street 1:2604 W 84TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5703
Practice Address - Country:US
Practice Address - Phone:305-824-8888
Practice Address - Fax:305-824-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8222261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health