Organization
CASANOVA ALF #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORMA ALICIA CASANOVA OWNER (OWNER)
(305) 343-9971
Entity
Organization
Contact information
Practice address
1084 W 65TH ST, HIALEAH, FL 33012-6459
(305) 557-2632
(305) 231-9212
Mailing address
1084 W 65TH ST, HIALEAH, FL 33012-6459
(305) 557-2632
(305) 231-9212
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9601
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
689640500
—
FL
Enumeration date
05/17/2007
Last updated
01/03/2014
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