Organization
KELLA HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEL GONZALEZ (PRESSIDENT)
(786) 752-0235
Entity
Organization
Contact information
Practice address
19 OCEANA AVE, KEY LARGO, FL 33037-4706
(786) 752-0235
(786) 206-3815
Mailing address
19 OCEANA DR, KEY LARGO, FL 33037-4706
(786) 752-0235
(786) 206-3815
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
003174600
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003174600
—
FL
Enumeration date
04/01/2011
Last updated
04/01/2011
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