Provider Demographics
NPI:1801371943
Name:SPRING OF LIFE CARE, INC.
Entity Type:Organization
Organization Name:SPRING OF LIFE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-237-1341
Mailing Address - Street 1:15891 SW 76TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2954
Mailing Address - Country:US
Mailing Address - Phone:786-237-1341
Mailing Address - Fax:
Practice Address - Street 1:11465 SW 57TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1003
Practice Address - Country:US
Practice Address - Phone:786-237-1341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility