Provider Demographics
NPI:1134337371
Name:LIZI HOME CARE II
Entity type:Organization
Organization Name:LIZI HOME CARE II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIGDALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-223-9761
Mailing Address - Street 1:4521 SW 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3816
Mailing Address - Country:US
Mailing Address - Phone:305-223-9761
Mailing Address - Fax:305-225-1289
Practice Address - Street 1:4521 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3816
Practice Address - Country:US
Practice Address - Phone:305-223-9761
Practice Address - Fax:305-225-1289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 10634310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility