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Organization

ANNIE C HORN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. XAVIER MOORE (EXECUTIVE DIRECTOR)
(478) 397-8354
Entity
Organization

Contact information

Practice address
17020 NW 47TH AVE, OPA LOCKA, FL 33055-4265
(478) 397-8354
Mailing address
17020 NW 47TH AVE, OPA LOCKA, FL 33055-4265
(478) 397-8354

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10751
FL

Other

Enumeration date
03/26/2007
Last updated
08/22/2020
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