Provider Demographics
NPI:1699971648
Name:A HOME AWAY FROM HOME ALF, INC.
Entity type:Organization
Organization Name:A HOME AWAY FROM HOME ALF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-402-4947
Mailing Address - Street 1:1851 SW 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7034
Mailing Address - Country:US
Mailing Address - Phone:305-229-1315
Mailing Address - Fax:305-402-3835
Practice Address - Street 1:1851 SW 142ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7034
Practice Address - Country:US
Practice Address - Phone:305-229-1315
Practice Address - Fax:305-402-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL141017200Medicaid