Organization
FRIENDLY HEARTS GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSNE OLIVARES (VICE-PRESIDENT)
(786) 253-9646
Entity
Organization
Contact information
Practice address
10542 SW 161ST AVE, MIAMI, FL 33196-4574
(305) 382-9646
(305) 382-9646
Mailing address
10542 SW 161ST AVE, MIAMI, FL 33196-4574
(305) 382-9646
(305) 382-9646
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
11-988-GH
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003928100
—
FL
Enumeration date
09/21/2011
Last updated
09/21/2011
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