Organization
ST. MARY ADULT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA FERNANDEZ (OWNER/ADMINISTRATOR)
(786) 393-8122
Entity
Organization
Contact information
Practice address
5716 SW 149TH PL, MIAMI, FL 33193-3011
(305) 408-0362
Mailing address
PO BOX 771120, MIAMI, FL 33177-0019
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL10555
FL
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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