Organization
ANDREA MARTIN HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY EDITH FARJE (OWNER)
(786) 718-4560
Entity
Organization
Contact information
Practice address
17851 SW 11TH CT, PEMBROKE PINES, FL 33029-4412
(786) 718-4560
Mailing address
17851 SW 11TH CT, PEMBROKE PINES, FL 33029-4412
(786) 718-4560
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11900
FL
3104A0625X
Assisted Living Facility (Mental Illness)
AL11900
FL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
AL11900
FL
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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