Provider Demographics
NPI:1760805865
Name:ISELA LOCHE
Entity Type:Organization
Organization Name:ISELA LOCHE
Other - Org Name:IVE HOME A L F
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISELA
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:LOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-255-7934
Mailing Address - Street 1:20020 SW 113TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1160
Mailing Address - Country:US
Mailing Address - Phone:305-255-7934
Mailing Address - Fax:305-278-8080
Practice Address - Street 1:20020 SW 113TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189-1160
Practice Address - Country:US
Practice Address - Phone:305-255-7934
Practice Address - Fax:305-278-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL7483311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL678002400Medicaid
FL140543800Medicaid