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Organization

FLORADEMA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FAITH B BAUTISTA (CEO)
(310) 351-0857
Entity
Organization

Contact information

Practice address
4265 MARINA CITY DR UNIT 1011, MARINA DEL REY, CA 90292-5801
(310) 351-0857
Mailing address
4265 MARINA CITY DR UNIT 1011, MARINA DEL REY, CA 90292-5801

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP1600X
Pastoral Counselor
171M00000X
Case Manager/Care Coordinator
177F00000X
Lodging Provider
208000000X
Pediatrics Physician
251K00000X
Public Health or Welfare Agency
Primary
251S00000X
Community/Behavioral Health Agency
251V00000X
Voluntary or Charitable Agency
373H00000X
Day Training/Habilitation Specialist
374U00000X
Home Health Aide
385H00000X
Respite Care

Other

Enumeration date
08/12/2025
Last updated
08/12/2025
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