Provider Demographics
NPI:1770169849
Name:LAS BAREA'S ALF LLC
Entity type:Organization
Organization Name:LAS BAREA'S ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-291-0822
Mailing Address - Street 1:4634 SW 164TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5198
Mailing Address - Country:US
Mailing Address - Phone:786-409-4458
Mailing Address - Fax:786-409-4458
Practice Address - Street 1:4634 SW 164TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5198
Practice Address - Country:US
Practice Address - Phone:786-409-4458
Practice Address - Fax:786-409-4458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13572OtherAHCA