Organization
MARTIN LEDERLY CARE LIVING
Active
Parent organization
N/A
Other names
SAME
Organization subpart
Yes
Provider details
NPI number
Legal business name
N/A
Authorized official
MS. LOUISE LEGER ELISE LPN (ALF ADMINISTRATOR)
(305) 762-4242
Entity
Organization
Contact information
Practice address
901 NW 63RD ST, MIAMI, FL 33150-4220
(305) 762-4242
(305) 762-4242
Mailing address
901 NW 63RD ST, MIAMI, FL 33150-4220
(305) 762-4242
(305) 762-4242
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AL10144
FL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
AL10144
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1411714200
—
FL
Enumeration date
10/31/2008
Last updated
10/31/2008
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