Organization
GREEN STREET ALF, CORP
Active
Other names
GREEN STREET ALF, CORP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS E CABALLERO (OWNER/ADMINISTRATOR)
(786) 274-0144
Entity
Organization
Contact information
Practice address
12262 SW 250TH TER, HOMESTEAD, FL 33032-5952
(786) 274-0144
(855) 299-0714
Mailing address
12262 SW 250TH TER, HOMESTEAD, FL 33032-5952
(786) 274-0144
(855) 299-0714
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12805
FL
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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