Organization
MICHAEL BANNISTER ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BANNISTER (OWNER)
(305) 752-2684
Entity
Organization
Contact information
Practice address
14636 SW 95TH LN, MIAMI, FL 33186-1040
(305) 752-2684
Mailing address
14636 SW 95TH LN, MIAMI, FL 33186-1040
(305) 752-2684
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
6905352
FL
Other
Enumeration date
12/27/2013
Last updated
12/27/2013
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