Organization
DIAZ HOME CARE ALF II, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE GONGAR (PRESIDENT)
(786) 282-6305
Entity
Organization
Contact information
Practice address
12211 SW 268 STREET, HOMESTEAD, FL 33032-7949
(786) 286-2826
(786) 601-7751
Mailing address
12211 SW 268 STREET, HOMESTEAD, FL 33032-7949
(786) 286-2826
(786) 601-7751
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11715
FL
310400000X
Assisted Living Facility
AL11715
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018310400
—
FL
Enumeration date
08/18/2010
Last updated
07/31/2020
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