Provider Demographics
NPI:1811047152
Name:CENTRE OF CITIZEN USA ENTERPRISES CORP.
Entity type:Organization
Organization Name:CENTRE OF CITIZEN USA ENTERPRISES CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER /ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:MILTHON
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-303-7073
Mailing Address - Street 1:343 W. 44TH ST.
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012
Mailing Address - Country:US
Mailing Address - Phone:786-558-7247
Mailing Address - Fax:786-558-7247
Practice Address - Street 1:343 W. 44TH ST.
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012
Practice Address - Country:US
Practice Address - Phone:786-558-7247
Practice Address - Fax:786-558-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL8954310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility