Organization
DIVINE LIVING IN HIALEAH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YADELKIS CRUZ (MANAGER)
(786) 417-7246
Entity
Organization
Contact information
Practice address
70 E 21ST ST, HIALEAH, FL 33010-2732
(305) 888-0779
(305) 888-8970
Mailing address
70 E 21ST ST, HIALEAH, FL 33010-2732
(305) 888-0779
(305) 888-8970
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L12000003110
FLORIDA DEPARTMENT OF STATE
FL
Enumeration date
04/09/2012
Last updated
04/09/2012
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