Organization
KBL MANOR INC.
Active
Other names
St. Joseph ALF
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KADIE LEE (ADMINISTRATOR)
(305) 251-4123
Entity
Organization
Contact information
Practice address
16100 SW 101ST AVE, MIAMI, FL 33157-3216
(305) 251-4123
Mailing address
16100 SW 101ST AVE, MIAMI, FL 33157-3216
(305) 251-4123
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL9516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142418100
—
FL
Enumeration date
11/10/2010
Last updated
11/10/2010
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