Organization
BUDDY'S PLACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REVILBRAY REVILLA (OWNER)
(305) 318-6593
Entity
Organization
Contact information
Practice address
229 LAUREL WAY, MIAMI SPRINGS, FL 33166-5138
(305) 318-6593
Mailing address
229 LAUREL WAY, MIAMI SPRINGS, FL 33166-5138
(305) 318-6593
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11626
FL
Other
Enumeration date
07/11/2010
Last updated
07/11/2010
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