Provider Demographics
NPI:1285090787
Name:KENDALL GARDENS ALF INC.
Entity type:Organization
Organization Name:KENDALL GARDENS ALF INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:EVA
Authorized Official - Last Name:DI TARANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-299-2519
Mailing Address - Street 1:8370 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7328
Mailing Address - Country:US
Mailing Address - Phone:786-391-3771
Mailing Address - Fax:786-391-3771
Practice Address - Street 1:8370 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7328
Practice Address - Country:US
Practice Address - Phone:786-391-3771
Practice Address - Fax:786-391-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12761310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12761OtherAHCA