Organization
EBENEZER FAMILY HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICH CAPESTANY (ADMINISTRATOR)
(786) 376-6767
Entity
Organization
Contact information
Practice address
6690 W 14TH AVE, HIALEAH, FL 33012-6239
(305) 857-9425
(305) 223-2371
Mailing address
6690 W 14TH AVE, HIALEAH, FL 33012-6239
(305) 857-9425
(305) 223-2371
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8519
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000208100
—
FL
05
—
000494700
—
FL
Enumeration date
11/24/2008
Last updated
01/08/2009
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