Provider Demographics
NPI:1932319191
Name:HAITIAN ELDERLY CENTER
Entity Type:Organization
Organization Name:HAITIAN ELDERLY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIXTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-893-2244
Mailing Address - Street 1:645 NE 127TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4824
Mailing Address - Country:US
Mailing Address - Phone:305-893-2244
Mailing Address - Fax:305-893-2142
Practice Address - Street 1:645 NE 127TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4824
Practice Address - Country:US
Practice Address - Phone:305-893-2244
Practice Address - Fax:305-893-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991642251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health