Provider Demographics
NPI:1821266875
Name:MOUNT SINAI CHISTIAN HOME, INC.
Entity Type:Organization
Organization Name:MOUNT SINAI CHISTIAN HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAYMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FONT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-685-5136
Mailing Address - Street 1:5190 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1606
Mailing Address - Country:US
Mailing Address - Phone:305-685-5136
Mailing Address - Fax:
Practice Address - Street 1:5190 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1606
Practice Address - Country:US
Practice Address - Phone:305-685-5136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10717310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL140659100Medicaid