Provider Demographics
NPI:1457605941
Name:GILD ADULT DAYCARE LLC.
Entity Type:Organization
Organization Name:GILD ADULT DAYCARE LLC.
Other - Org Name:GILD ADULT DAYCARE LLC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESSALINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-484-7057
Mailing Address - Street 1:18901 SW 106TH AVE STE A118A120
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7661
Mailing Address - Country:US
Mailing Address - Phone:305-484-7057
Mailing Address - Fax:
Practice Address - Street 1:18901 SW 106TH AVE STE A118A120
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7661
Practice Address - Country:US
Practice Address - Phone:305-484-7057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9220311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility