Organization
DE BLANCA HOME III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA LOPETEGUI ADMINISTRATOR (OWNER)
(305) 551-7721
Entity
Organization
Contact information
Practice address
4010 SW 107TH AVE, MIAMI, FL 33165-4813
(305) 220-8616
Mailing address
4010 SW 107TH AVE, MIAMI, FL 33165-4813
(305) 220-8616
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL9317
FL
Other
Enumeration date
06/19/2008
Last updated
06/19/2008
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