Provider Demographics
NPI:1821702242
Name:ALGARROBO ADULT DAY CARE LLC
Entity Type:Organization
Organization Name:ALGARROBO ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALBOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-222-8259
Mailing Address - Street 1:208 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6034
Mailing Address - Country:US
Mailing Address - Phone:786-360-7503
Mailing Address - Fax:
Practice Address - Street 1:208 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6034
Practice Address - Country:US
Practice Address - Phone:786-360-7503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9549OtherAHCA