Provider Demographics
NPI:1124610373
Name:FAMILIA ADULT DAY CARE INC
Entity type:Organization
Organization Name:FAMILIA ADULT DAY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-923-2159
Mailing Address - Street 1:3440 W 100TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2103
Mailing Address - Country:US
Mailing Address - Phone:305-298-1043
Mailing Address - Fax:
Practice Address - Street 1:5951 NW 173RD DR # B10
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5112
Practice Address - Country:US
Practice Address - Phone:305-923-2159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9494Medicaid