Organization
CASA DE LOS ABUELOS ALF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAZARA MARTINEZ (PRESIDENT)
(813) 532-9732
Entity
Organization
Contact information
Practice address
6521 W HANNA AVE, TAMPA, FL 33634-4959
(813) 532-9732
Mailing address
6521 W HANNA AVE, TAMPA, FL 33634-4959
(813) 532-9732
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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