Provider Demographics
NPI:1699300277
Name:RITA DE ACACIAS ALF CORP
Entity type:Organization
Organization Name:RITA DE ACACIAS ALF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAQUIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZABALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-590-4546
Mailing Address - Street 1:5241 LIMA PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-1624
Mailing Address - Country:US
Mailing Address - Phone:404-590-4546
Mailing Address - Fax:
Practice Address - Street 1:5241 LIMA PL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-1624
Practice Address - Country:US
Practice Address - Phone:404-590-4546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility