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Organization

MACTOWN, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GABRIEL JOSEPH PEREZ (DIRECTOR OF FINANCE)
(305) 758-4485
Entity
Organization

Contact information

Practice address
151 NE 62ND ST, MIAMI, FL 33138-5926
(305) 758-4485
(305) 756-9990
Mailing address
151 NE 62ND ST, MIAMI, FL 33138-5926
(305) 758-4485
(305) 756-9990

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
49298
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02497798
FL
Enumeration date
09/28/2007
Last updated
09/28/2007
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