Organization
ELENA PALACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTO LUIS DOMINGUEZ (OWNER)
(786) 615-4139
Entity
Organization
Contact information
Practice address
4012 SW 154TH CT, MIAMI, FL 33185-5442
(786) 615-4139
Mailing address
4012 SW 154TH CT, MIAMI, FL 33185-5442
(786) 615-4139
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
FL
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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