Organization
RESIDENCIA ILENIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAXIMO HERNANDEZ (VICE PRESIDENT)
(305) 642-5407
Entity
Organization
Contact information
Practice address
475 SW 25TH AVE, MIAMI, FL 33135-2922
(305) 642-5407
Mailing address
475 SW 25TH AVE, MIAMI, FL 33135-2922
(305) 642-5407
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11469
FL
Other
Enumeration date
05/22/2009
Last updated
05/22/2009
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