Provider Demographics
NPI:1801052493
Name:EMU ASSISTED LIVING FACILITY
Entity type:Organization
Organization Name:EMU ASSISTED LIVING FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:URRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-383-0622
Mailing Address - Street 1:10241 SW 134TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-2861
Mailing Address - Country:US
Mailing Address - Phone:305-383-0622
Mailing Address - Fax:
Practice Address - Street 1:10241 SW 134TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2861
Practice Address - Country:US
Practice Address - Phone:305-383-0622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-02
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11099310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility