Organization
SAN MARTIN DE PORRAS ALF, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MACARIO HUAITALLA (PRESIDENT)
(305) 305-9882
Entity
Organization
Contact information
Practice address
1840 NW 15TH ST, MIAMI, FL 33125-2202
(305) 305-9882
Mailing address
1840-42 NW 15 STREET, MIAMI, FL 33125
(305) 305-9882
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL9895
FL
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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