Provider Demographics
NPI:1841409091
Name:NEW LIFE RETIREMENT HOME
Entity Type:Organization
Organization Name:NEW LIFE RETIREMENT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREJON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-557-7825
Mailing Address - Street 1:1001 W 50TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3423
Mailing Address - Country:US
Mailing Address - Phone:305-557-7825
Mailing Address - Fax:305-225-1289
Practice Address - Street 1:1001 W 50TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3423
Practice Address - Country:US
Practice Address - Phone:305-557-7825
Practice Address - Fax:305-225-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9123310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility