NPI | 1669772588 |
---|---|
Former Legal Business Name | BLACK CORAL GALLERY INC |
Entity Type | Organization |
Authorized Contact | ALFREDO LOPEZ Owner 786-371-4697 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 9152) |
Enumeration Date | 2010-10-26 |
Last Update Date | 2022-09-20 |