Organization
HERNANDEZ ALF INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISANDRA HERNANDEZ (OWNER)
(813) 270-6040
Entity
Organization
Contact information
Practice address
2507 W IDLEWILD AVE, TAMPA, FL 33614-6107
(813) 270-6040
(813) 531-6824
Mailing address
2507 W IDLEWILD AVE, TAMPA, FL 33614
(813) 270-6040
(813) 531-6824
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AL11932
FL
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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