Provider Demographics
NPI:1982205019
Name:CANTILLO LOVE & CARE LLC
Entity Type:Organization
Organization Name:CANTILLO LOVE & CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARELYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-443-7674
Mailing Address - Street 1:1045 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1922
Mailing Address - Country:US
Mailing Address - Phone:305-883-1915
Mailing Address - Fax:305-883-2080
Practice Address - Street 1:1045 W 23RD ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1922
Practice Address - Country:US
Practice Address - Phone:305-883-1915
Practice Address - Fax:305-883-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility