Organization
DE BLANCA HOME I
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA LOPETEGUI ADMINISTRATOR (OWNER)
(305) 220-8616
Entity
Organization
Contact information
Practice address
11901 SW 25TH TER, MIAMI, FL 33175-2405
(305) 220-8616
Mailing address
11901 SW 25TH TER, MIAMI, FL 33175-2405
(305) 220-8616
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
AL 9602
FL
Other
Enumeration date
06/19/2008
Last updated
06/19/2008
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