Organization
MICASA ALF LLC
Active
Other names
MICASA SENIOR LIVING
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ROZENBERG (OWNER)
(954) 646-1212
Entity
Organization
Contact information
Practice address
6021 DUVAL ST, HOLLYWOOD, FL 33024-7961
(954) 613-1163
Mailing address
6920 SW 56TH CT, DAVIE, FL 33314-7004
(954) 613-1163
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106326300
—
FL
01
—
AL13462
LICENSE
FL
Enumeration date
04/04/2019
Last updated
08/10/2020
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