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Organization
KELLA HOMES LLC
Active
Organization
KELLA HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEL GONZALEZ (PRESIDENT)
(786) 752-0235
Entity
Organization
Contact information
Practice address
27153 SW 134TH CT, HOMESTEAD, FL 33032-7782
(786) 752-0235
(786) 206-3815
Mailing address
27153 SW 134TH CT, HOMESTEAD, FL 33032-7782
(786) 752-0235
(786) 206-3815
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
691670896
FL
374700000X
Technician
EMT300255
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003174600
—
FL
05
—
691670896
—
FL
Enumeration date
06/26/2009
Last updated
06/28/2013
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