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Organization
ST. MARY ADULT CARE
Active
Organization
ST. MARY ADULT CARE
Active
Other names
ST. MARY ADULT CARE II
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELENA FERNANDEZ (OWNER/ ADMINISTRATOR)
(786) 393-8122
Entity
Organization
Contact information
Practice address
11271 SW 229TH TER, MIAMI, FL 33170-7563
(786) 504-2397
(305) 408-1263
Mailing address
PO BOX 771120, MIAMI, FL 33177-0019
(786) 393-8122
(305) 408-1263
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL11069
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142850100
—
FL
05
—
692848000
—
FL
Enumeration date
02/12/2008
Last updated
02/19/2014
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