Provider Demographics
NPI:1851663777
Name:MARIE DESSALINES
Entity Type:Organization
Organization Name:MARIE DESSALINES
Other - Org Name:GUIL ADULT FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESSALINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-293-8005
Mailing Address - Street 1:18539 SW 133RD AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-4206
Mailing Address - Country:US
Mailing Address - Phone:786-293-8005
Mailing Address - Fax:
Practice Address - Street 1:18539 SW 133RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4206
Practice Address - Country:US
Practice Address - Phone:786-293-8005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6906511311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home