Provider Demographics
NPI:1700436748
Name:MILLY'S FAMILY HOME LLC
Entity Type:Organization
Organization Name:MILLY'S FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:MILEYDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-380-1447
Mailing Address - Street 1:8105 SW 136TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4188
Mailing Address - Country:US
Mailing Address - Phone:305-380-1447
Mailing Address - Fax:786-353-2245
Practice Address - Street 1:8105 SW 136TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4188
Practice Address - Country:US
Practice Address - Phone:305-380-1447
Practice Address - Fax:786-353-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility