Organization
LIFE TIME ALF CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY DIAZ (PRESIDENT-OWNER)
(305) 562-9069
Entity
Organization
Contact information
Practice address
822 SW 89TH AVE, MIAMI, FL 33174-3221
(305) 562-9069
Mailing address
822 SW 89TH AVE, MIAMI, FL 33174-3221
(305) 562-9069
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL-11350
FL
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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