Organization
LUCILLES LOVING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY RICHARD DENBOW (MANAGER)
(305) 623-0710
Entity
Organization
Contact information
Practice address
17820 NW 22ND AVE, MIAMI GARDENS, FL 33056-4736
(305) 623-0710
(305) 622-9629
Mailing address
17820 NW 22ND AVE, MIAMI GARDENS, FL 33056-4736
(305) 623-0710
(305) 622-9629
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AL3952
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140490300
—
FL
Enumeration date
09/25/2014
Last updated
09/25/2014
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