Organization
LOS ABUELITO'S RESIDENCE HOME II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANITA LOPEZ (OWNER-ADMINISTRATOR)
(305) 318-7093
Entity
Organization
Contact information
Practice address
6360 LAKE JUNE RD, MIAMI LAKES, FL 33014-3047
(786) 360-4544
Mailing address
6360 LAKE JUNE RD, MIAMI LAKES, FL 33014-3047
(786) 360-4544
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
11752
FL
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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