Organization
ST JUDE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRTA M DEARMAS (OWNER/ADMINISTRATOR)
(305) 220-4335
Entity
Organization
Contact information
Practice address
9981 SW 42ND TER, MIAMI, FL 33165-5044
(305) 220-4335
(305) 220-4335
Mailing address
9981 SW 42ND TER, MIAMI, FL 33165-5044
(305) 220-4335
(305) 220-4335
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL7863
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142126300
—
FL
Enumeration date
11/13/2010
Last updated
12/27/2010
Update your record
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