Provider Demographics
NPI:1295157683
Name:CLAUDINA FAMILY HOME, LLC
Entity type:Organization
Organization Name:CLAUDINA FAMILY HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:WILFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-878-2848
Mailing Address - Street 1:4911 S.W. 132 AVE.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:786-536-6734
Mailing Address - Fax:786-536-5145
Practice Address - Street 1:4911 S.W. 132 AVE.
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:786-536-6734
Practice Address - Fax:786-536-5145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-20
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12458310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility