Organization
DE LAS MERCEDES ALF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAILY PENA (ADMINISTRATOR)
(813) 785-2894
Entity
Organization
Contact information
Practice address
7012 N ORLEANS AVE, TAMPA, FL 33604-4734
(813) 785-2894
(813) 930-0545
Mailing address
7012 N ORLEANS AVE, TAMPA, FL 33604-4734
(813) 785-2894
(813) 930-0545
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
12623
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12623
AHCA
FL
Enumeration date
09/06/2018
Last updated
09/06/2018
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