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Organization

KBL MANOR INC

Active
Other names
St. Joseph A.L.F.
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KADIE C KISSOONLAL (ADMINISTRATOR)
(305) 251-4123
Entity
Organization

Contact information

Practice address
16100 SW 101ST AVE, MIAMI, FL 33157-3216
(305) 251-4123
Mailing address
16100 SW 101ST AVE, MIAMI, FL 33157-3216
(305) 251-4123

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL9516
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
142418100
FL
Enumeration date
04/10/2009
Last updated
04/10/2009
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