Provider Demographics
NPI:1912533704
Name:GARDENS HOME ALF LLC
Entity Type:Organization
Organization Name:GARDENS HOME ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-320-3563
Mailing Address - Street 1:18201 NW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-3129
Mailing Address - Country:US
Mailing Address - Phone:786-320-6195
Mailing Address - Fax:786-703-5951
Practice Address - Street 1:18201 NW 57TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-3129
Practice Address - Country:US
Practice Address - Phone:786-320-6195
Practice Address - Fax:786-703-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility