Provider Demographics
NPI:1306989835
Name:PIONEER ADULT RESIDENTIAL FACILITY INC.
Entity type:Organization
Organization Name:PIONEER ADULT RESIDENTIAL FACILITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSITANT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-856-5103
Mailing Address - Street 1:1311 BIARRITZ DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3635
Mailing Address - Country:US
Mailing Address - Phone:305-865-2851
Mailing Address - Fax:305-856-5104
Practice Address - Street 1:1311 BIARRITZ DR
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3635
Practice Address - Country:US
Practice Address - Phone:305-865-2851
Practice Address - Fax:305-856-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL38683104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness