Organization
MOM EXCELLENT ALF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDY CRUZ (ADMINISTRATOR)
(305) 698-6067
Entity
Organization
Contact information
Practice address
8905 NW 120TH TER, HIALEAH, FL 33018-4166
(305) 698-6067
Mailing address
8905 NW 120TH TER, HIALEAH, FL 33018-4166
(305) 698-6067
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL 10556
FL
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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