Organization
COLONIAL DR SENIOR RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODALYS GOVEA (OWNER)
(305) 554-9345
Entity
Organization
Contact information
Practice address
10220 SW 164TH ST, MIAMI, FL 33157-3167
(305) 554-9345
(305) 225-1289
Mailing address
10220 SW 164TH ST, MIAMI, FL 33157-3167
(305) 554-9345
(305) 225-1289
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL 9970
FL
Other
Enumeration date
05/17/2007
Last updated
08/22/2020
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