Provider Demographics
NPI:1891941209
Name:YESENIA ALF
Entity Type:Organization
Organization Name:YESENIA ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REGLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABRADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-229-8217
Mailing Address - Street 1:15608 SW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-2802
Mailing Address - Country:US
Mailing Address - Phone:305-408-1698
Mailing Address - Fax:305-223-2371
Practice Address - Street 1:15608 SW 63RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-2802
Practice Address - Country:US
Practice Address - Phone:305-408-1698
Practice Address - Fax:305-223-2371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL9799310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL143034300Medicaid