Organization
JC & C ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EYLIN R. LUCAS (OIWNER)
(786) 281-1583
Entity
Organization
Contact information
Practice address
158 W 10TH ST, HIALEAH, FL 33010-4007
(786) 600-8679
(786) 600-8679
Mailing address
158 W 10TH ST, HIALEAH, FL 33010-4007
(786) 600-8679
(786) 600-8679
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003908000
—
FL
Enumeration date
10/22/2021
Last updated
10/22/2021
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