Provider Demographics
NPI:1801010335
Name:MAKILLIA DWELLE
Entity Type:Organization
Organization Name:MAKILLIA DWELLE
Other - Org Name:AARON'S GARDEN RESIDENCE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAKILLIA
Authorized Official - Middle Name:MYIEIA
Authorized Official - Last Name:DWELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-446-4383
Mailing Address - Street 1:6950 NW 21ST CT
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-2026
Mailing Address - Country:US
Mailing Address - Phone:954-446-4383
Mailing Address - Fax:954-586-0452
Practice Address - Street 1:6950 NW 21ST CT
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-2026
Practice Address - Country:US
Practice Address - Phone:954-446-4383
Practice Address - Fax:954-586-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906059311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home