Organization
GRANDPARENTS CLUB ADULT DAY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA LYNN NAVA (OWNER)
(305) 890-1371
Entity
Organization
Contact information
Practice address
4729 NW 183 STREET, MIAMI, FL 33055
(786) 916-5306
(786) 916-5307
Mailing address
4729 NW 183 STREET, MIAMI, FL 33055
(786) 916-5306
(786) 916-5307
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016145700
—
FL
01
—
018327000
MEDICAID
FL
Enumeration date
06/25/2014
Last updated
12/01/2016
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