Provider Demographics
NPI:1699224964
Name:EL JARDIN ADULT DAY CARE LLC
Entity type:Organization
Organization Name:EL JARDIN ADULT DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-456-0122
Mailing Address - Street 1:4195 SW 137TH AVE
Mailing Address - Street 2:SUITE #5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6479
Mailing Address - Country:US
Mailing Address - Phone:305-456-0122
Mailing Address - Fax:305-456-0122
Practice Address - Street 1:4195 SW 137TH AVE
Practice Address - Street 2:SUITE #5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6479
Practice Address - Country:US
Practice Address - Phone:305-456-0122
Practice Address - Fax:305-456-0122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9361261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care