Provider Demographics
NPI:1740812262
Name:LEEWARD ISLE HOMES LLC
Entity type:Organization
Organization Name:LEEWARD ISLE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA ARIOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-718-9134
Mailing Address - Street 1:740 NW 85TH WAY
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-441-9395
Mailing Address - Fax:954-252-4028
Practice Address - Street 1:740 NW 85TH WAY
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-441-9395
Practice Address - Fax:954-252-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility