Organization
LLANES RESIDENCE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUVENAL LLANES (OWNER)
(305) 485-4905
Entity
Organization
Contact information
Practice address
4712 SW 143RD AVE, MIAMI, FL 33175-4329
(305) 485-4905
(305) 485-4905
Mailing address
4712 SW 143RD AVE, MIAMI, FL 33175-4329
(305) 485-4905
(305) 485-4905
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10133
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141673100
—
FL
Enumeration date
08/29/2008
Last updated
08/29/2008
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