Organization
CASABLANCA ELITE ADULT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE TRUJILLO (OWNER)
(786) 838-3922
Entity
Organization
Contact information
Practice address
509 NW 103RD AVE, PLANTATION, FL 33324-1625
(786) 838-3922
Mailing address
509 NW 103RD AVE, PLANTATION, FL 33324-1625
(786) 838-3922
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13754
AHCA
FL
Enumeration date
12/07/2022
Last updated
12/07/2022
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