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Organization
JESUS GROUP HOME LLC.
Active
Organization
JESUS GROUP HOME LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZULY MARTINEZ HHA (CEO)
(786) 266-6852
Entity
Organization
Contact information
Practice address
15504 SW 104TH AVE, MIAMI, FL 33157-1458
(786) 592-2281
Mailing address
15504 SW 104TH AVE, MIAMI, FL 33157-1458
(786) 592-2281
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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