Provider Demographics
NPI:1760804280
Name:IVEHOME II ALF INC.
Entity Type:Organization
Organization Name:IVEHOME II ALF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:ASPACIO
Authorized Official - Last Name:LOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-501-4311
Mailing Address - Street 1:22636 SW 125TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33170-6318
Mailing Address - Country:US
Mailing Address - Phone:786-501-4311
Mailing Address - Fax:305-278-8080
Practice Address - Street 1:22636 SW 125TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33170-6318
Practice Address - Country:US
Practice Address - Phone:786-501-4311
Practice Address - Fax:305-278-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10826311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL142588900Medicaid