Organization
CK GROUP HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATENA BROUSSARD (OWNER)
(305) 788-1836
Entity
Organization
Contact information
Practice address
19431 NW 23RD CT, OPA LOCKA, FL 33056-2653
(305) 788-1836
Mailing address
19431 NW 23RD CT, OPA LOCKA, FL 33056-2653
(305) 788-1836
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
230393
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230393
LICENSE
FL
Enumeration date
06/01/2012
Last updated
09/08/2025
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