Provider Demographics
NPI:1447449731
Name:ASISITED LIVING MANAGEMENT GROUP
Entity type:Organization
Organization Name:ASISITED LIVING MANAGEMENT GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:DUASSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-218-8705
Mailing Address - Street 1:2151 SW 24TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3732
Mailing Address - Country:US
Mailing Address - Phone:305-446-5076
Mailing Address - Fax:305-854-5921
Practice Address - Street 1:2787 SW 33RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2845
Practice Address - Country:US
Practice Address - Phone:305-446-5076
Practice Address - Fax:305-854-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8520310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility