Provider Demographics
NPI:1366918450
Name:LIFE AND LOVE ADULT DAYCARE CENTER CORP.
Entity type:Organization
Organization Name:LIFE AND LOVE ADULT DAYCARE CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:ORLANDO
Authorized Official - Last Name:CALZADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-202-2229
Mailing Address - Street 1:419 W 49TH ST # 102-103
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3654
Mailing Address - Country:US
Mailing Address - Phone:305-310-1356
Mailing Address - Fax:
Practice Address - Street 1:419 W 49TH ST # 102-103
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3654
Practice Address - Country:US
Practice Address - Phone:305-310-1356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicaid