Provider Demographics
NPI:1215520945
Name:ROQUE GROUP HOMES INC
Entity type:Organization
Organization Name:ROQUE GROUP HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAIKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROQUE RUANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-547-1568
Mailing Address - Street 1:6071 NW 198TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4857
Mailing Address - Country:US
Mailing Address - Phone:786-547-1568
Mailing Address - Fax:
Practice Address - Street 1:6071 NW 198TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4857
Practice Address - Country:US
Practice Address - Phone:786-547-1568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities