Provider Demographics
NPI:1780072140
Name:AMOR DE JESUS II, CORP.
Entity type:Organization
Organization Name:AMOR DE JESUS II, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-201-1499
Mailing Address - Street 1:6400 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1949
Mailing Address - Country:US
Mailing Address - Phone:786-201-1499
Mailing Address - Fax:305-552-7559
Practice Address - Street 1:6400 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1949
Practice Address - Country:US
Practice Address - Phone:786-201-1499
Practice Address - Fax:305-552-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12586310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility