Provider Demographics
NPI:1942595335
Name:PUPA ALF, CORP.
Entity Type:Organization
Organization Name:PUPA ALF, CORP.
Other - Org Name:PUPA ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:PROF
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:SOCARRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-829-0235
Mailing Address - Street 1:7851 NW 197TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6409
Mailing Address - Country:US
Mailing Address - Phone:305-829-0235
Mailing Address - Fax:305-829-0235
Practice Address - Street 1:7851 NW 197TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-6409
Practice Address - Country:US
Practice Address - Phone:305-829-0235
Practice Address - Fax:305-829-0235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11990310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility