Provider Demographics
NPI:1962815167
Name:COZY CARE RESIDENCE ALF
Entity Type:Organization
Organization Name:COZY CARE RESIDENCE ALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNICE
Authorized Official - Middle Name:B
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-308-4315
Mailing Address - Street 1:1130 NE 136TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-3818
Mailing Address - Country:US
Mailing Address - Phone:305-308-4315
Mailing Address - Fax:305-819-8840
Practice Address - Street 1:1130 NE 136TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-3818
Practice Address - Country:US
Practice Address - Phone:305-308-4315
Practice Address - Fax:305-819-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12490310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility