Organization
EBENEZER PALACE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODALIS MACHIN (OWNER)
(305) 713-0491
Entity
Organization
Contact information
Practice address
290 W 48TH ST, HIALEAH, FL 33012-3952
(305) 713-0491
(786) 803-8455
Mailing address
290 W 48TH ST, HIALEAH, FL 33012-3952
(305) 713-0491
(786) 803-8455
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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