Organization
SAN JUDAS HOME CARE III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRECIA PURI (ADMINISTRATION)
(305) 222-5456
Entity
Organization
Contact information
Practice address
251 NW 108TH ST, MIAMI, FL 33168-3222
(786) 222-5469
Mailing address
251 NW 108TH ST, MIAMI, FL 33168-3222
(786) 222-5469
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
12298
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007396600
—
FL
Enumeration date
08/08/2013
Last updated
08/08/2013
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