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Organization

JUDITH'S ASSISTED LIVING FACILITY, INC

Active
Other names
Yudith's Alf
Organization subpart
No

Provider details

NPI number
Authorized official
RUBEN DOMOGUEZ (ADMINISTRATOR)
(813) 453-2480
Entity
Organization

Contact information

Practice address
4542 WEST HIAWATHA STREET, TAMPA, FL 33614
(813) 453-4542
(813) 412-7830
Mailing address
4542 WEST HIAWATHA STREET, TAMPA, FL 33614
(813) 453-4542
(813) 412-7830

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
9484
FL

Other

Enumeration date
12/11/2013
Last updated
12/11/2013
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