Organization
GENESIS I ALF, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIONYS MATOS (PRESIDENT)
(786) 955-5782
Entity
Organization
Contact information
Practice address
1445 NW 116TH TER, MIAMI, FL 33167-3239
(305) 681-9643
(305) 681-9643
Mailing address
1445 NW 116TH TER, MIAMI, FL 33167-3239
(305) 681-9643
(305) 681-9643
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1425323-00
—
FL
Enumeration date
05/23/2013
Last updated
05/23/2013
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