Organization
ML WILLOW HAVEN ALF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCITA VINCENT (OWNER/ADMIN)
(305) 417-0526
Entity
Organization
Contact information
Practice address
1220 NE 207TH ST, MIAMI, FL 33179-2019
(305) 417-0526
Mailing address
1220 NE 207TH ST, MIAMI, FL 33179-2019
(305) 417-0526
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10457
AHCA
FL
Enumeration date
05/25/2021
Last updated
05/25/2021
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