Provider Demographics
NPI:1336562057
Name:MERY ALF CORP
Entity Type:Organization
Organization Name:MERY ALF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MERIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOMPART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-439-6533
Mailing Address - Street 1:12200 2ND ST SW
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184
Mailing Address - Country:US
Mailing Address - Phone:786-439-6533
Mailing Address - Fax:
Practice Address - Street 1:12200 2ND ST SW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184
Practice Address - Country:US
Practice Address - Phone:786-439-6533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL10060310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility